Objective. To determine the effects of multidisciplinary home rehabilitation (MHR) on functional and quality of life (QOL) outcomes following hip fracture surgery. Methods. Systematic review methodology suggested by Cochrane Collboration was adopted. Reviewers independently searched the literature, selected the studies, extracted data, and performed critical appraisal of studies. Summary of the results of included studies was provided. Results. Five studies were included. Over the short-term, functional status and lower extremity strength were better in the MHR group compared to the no treatment group (NT). Over the long-term, the MHR group showed greater improvements in balance confidence, functional status, and lower extremity muscle strength compared to NT group, whereas the effect on QOL and mobility was inconsistent across the studies. Several methodological issues related to study design were noted across the studies. Conclusion. The MHR was found to be more effective compared to the NT in improving functional status and lower extremity strength in patients with hip fracture surgery. Results of this review do not make a strong case for MHR due to high risk of bias in the included studies. Further research is required to accurately characterize the types of disciplines involved in MHR and frequency and dosage of intervention. 1. Introduction Hip fracture is common across all age groups but is more common in older adults. Most hip fractures are treated surgically [1]. Hip fractures place tremendous burden on health care systems [2, 3]. Individuals with hip fractures have increased mortality, long-term disability, and functional dependence since most older adults do not attain pre-injury functional levels [4]. Moreover, impairment in quality of life (QOL), psychological and social domains, and fall related efficacy are also reported following a hip fracture [5, 6]. Specific interventions have been designed to reduce the impact of hip fracture on these domains. The components of an intervention depend on targeted outcome. Individuals with hip fracture consider increase in mobility and functions to be the preferred outcomes when asked about their recovery expectations following hip fracture [7]. Postsurgical rehabilitation programs aim to reduce disability and improve mobility, functions, balance, strength and QOL following hip fracture [8]. They are implemented in variety of settings such as inpatient, outpatient, or home-based rehabilitation. Posthip fracture rehabilitation may involve multidisciplinary care, which includes services provided by
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