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Osteoporosis International

, Volume 22, Issue 5, pp 1289–1322 | Cite as

Exercise prescription after fragility fracture in older adults: a scoping review

  • L. M. FeehanEmail author
  • C. A. Beck
  • S. R. Harris
  • D. L. MacIntyre
  • L. C. Li
Review

Abstract

The purpose of this study is to identify and chart research literature on safety, efficacy, or effectiveness of exercise prescription following fracture in older adults. We conducted a systematic, research-user-informed, scoping review. The population of interest was adults aged ≥45 years with any fracture. “Exercise prescription” included post-fracture therapeutic exercise, physical activity, or rehabilitation interventions. Eligible designs included knowledge synthesis studies, primary interventional studies, and observational studies. Trained reviewers independently evaluated citations for inclusion. A total of 9,415 citations were reviewed with 134 citations (119 unique studies) identified: 13 knowledge syntheses, 95 randomized or controlled clinical trials, and 11 “other” designs, representing 74 articles on lower extremity fractures, 34 on upper extremity, eight on vertebral, and three on mixed body region fractures. Exercise prescription characteristics were often missing or poorly described. Six general categories emerged describing exercise prescription characteristics: timing post-fracture, person prescribing, program design, functional focus, exercise script parameters, and co-interventions. Upper extremity and ankle fracture studies focused on fracture healing or structural impairment outcomes, whereas hip fracture studies focused more on activity limitation outcomes. The variety of different outcome measures used made pooling or comparison of outcomes difficult. There was insufficient information to identify evidence-informed parameters for safe and effective exercise prescription for older adults following fracture. Key gaps in the literature include limited numbers of studies on exercise prescription following vertebral fracture, poor delineation of effectiveness of different strategies for early post-fracture mobilization following upper extremity fracture, and inconsistent details of exercise prescription characteristics after lower extremity fracture.

Keywords

Exercise prescription Fragility fracture Older adults Osteoporosis Scoping review 

Notes

Acknowledgments

This study was funded in part by a Canadian Institutes of Health Research (CIHR) Knowledge Synthesis Grant (FRN 86244). The principal investigator for this study is Susan R. Harris.

Conflicts of interest

None.

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2010

Authors and Affiliations

  • L. M. Feehan
    • 1
    • 3
    Email author
  • C. A. Beck
    • 2
  • S. R. Harris
    • 1
  • D. L. MacIntyre
    • 1
  • L. C. Li
    • 1
  1. 1.Department of Physical TherapyUniversity of British ColumbiaVancouverCanada
  2. 2.Woodward LibraryUniversity of British ColumbiaVancouverCanada
  3. 3.Arthritis Research Centre of CanadaVancouverCanada

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