Is Occupational Therapy After Hip Fracture Surgery Effective in Improving Function? A Systematic Review and Meta-analysis of Randomized Controlled Studies

Objectives This study is aimed to evaluate whether occupational therapy (OT) improves activities of daily living (ADL) and overall physical functioning of patients after hip fracture surgery (HFS). Data sources PubMed-Medline, Embase, and Cochrane Library databases. Review methods We searched for randomized controlled trials comparing OT with comprehensive postoperative care (without OT) after HFS. A pairwise meta-analysis using fixed- and random-effects models was performed. The primary outcome of interest was performance of ADL assessed in any manner. The secondary outcomes were other functional parameters: 1) physical function; 2) health perception and emotion; and 3) fall occurrence. Effect sizes were computed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Results Five randomized controlled trials including a total of 524 participants were retrieved. There was a trend towards improvement in ADL, physical function, and fall occurrence, these changes were not significant. However, health perception and patient emotions improved significantly in the OT group (SMD=0.391; 95% CI, 0.104–0.678; p=0.008). Conclusion OT after HFS seems to improve overall function. Indeed, the positive effects of OT on health perception and emotions were evident. Therefore, OT can be suggested in comprehensive rehabilitation programs after HFS. Address correspondence to Jae-Young Lim, MD, PhD, Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea; Telephone: +82 31 787 7732; Fax: +82 31 787 4056, E-mail: drlim1@snu.ac.kr Funding: This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC15C1189). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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