Rehabilitation following hip fracture

© Springer International Publishing Switzerland 2017After a hip fracture operation an older person’s recovery is enhanced if they are provided with an optimistic, well-coordinated rehabilitation programme. A rehabilitation approach involves a team of various disciplines (physiotherapy, occupational therapy, nutrition, social work, psychology, medicine) who meet regularly, set goals, provide appropriate treatments, review progress towards these goals with the patient and assess outcomes. Where teams are not available elements of this approach can be included in a care pathway developed with patients and families. Cohort studies suggest that following hip fracture only 40–60 % of people who survive are likely to recover their pre-fracture level of mobility or ability to perform instrumental activities of daily living (ADLs). The time for recovery of different functional abilities varies widely; from within 4 months for upper limb ADLs to much longer for balance and gait and walking ability. Structured exercise programmes that include progressive resistance training or continue for at least 12 weeks can make moderate to large improvements in overall mobility following hip fracture. This chapter outlines evidence-based recommendations for the key elements of rehabilitation programmes extending beyond the hospital setting, with particular emphasis on structured exercise programmes aiming to maximise functional recovery