Introduction

Evidence-Based Physical Therapy (EBP) uses the best research evidence with clinical expertise and user’s preferences to produce the most appropriate and effective care. At week 43 in 2024, we had Blended Intensive program (BIP) in Czech Republic, Charles University about EBP. This BIP program opened with welcome words of the president of The European Network of Physiotherapy in Higher Education (ENPHE) and followed with the basis of EBP and teachers who highlighted the main challenges at different Physical Therapy fields.

More than 43 physiotherapy students and 9 teachers (Picture 1) from five universities (Savonia University of Applied Sciences, Finland, Universidade da Coruña, Spain, Charles University Prague, Universidad Europea de Madrid, Spain and CEERRF, France), actively participated this week and shared experiential group dynamics and social activities. Students worked together and wrote articles devoted to the following themes: Evidence Based in sport, prevention, injuries, neurological diseases, respiratory diseases, cardiovascular diseases, children and older adults. In this learning task, students practiced conducting a mini review and using PEDro scale to assess the quality of a studies. In the following you can consult the work presented by the students on older adult topic.

Background

Hip fractures are common injuries for older adults due to the physical changes they undergo as they age (e.g., the tendency to have arthritis, osteoporosis, loss of balance, visual impairment, slow reflexes, etc.). The fact that life expectancy has increased in the last decades means a higher number of adults may require rehabilitation due to this problem. And we, as physiotherapists, need to be able to provide the best possible solution. We then wondered: are multicomponent rehabilitation programs designed to help older adults after hip fracture efficient? To find a response to this question we searched for evidence-based information through PubMed database to obtain the most up-to-date articles regarding this topic. The aim of this mini review was to assess the outcomes of different rehabilitation programs. Even with different approaches and techniques, they all share the same goal which is to restore the functionality of the fractured hip.

Methods

We started out by establishing the eligibility criteria for our search (Picture 2). Some of those were determined by the guidelines of the Blended Intensive Program learning task, such as using only Randomized Controlled Trials and selecting only 5 articles, one for each member of the group. We added some more, which were: using articles published in the last 5 years, subjects being over 60 years old and with hip fractures. The keywords we used were hip fracture, elderly adults, and physical therapy. Initially, we found 1320 articles. Of those, 1278 were left out because of the filters we applied to meet our criteria. We were left with 42 articles and out of those we selected the 5 (Che et al. 2023, Karlsson et al. 2020, Magaziner et al. 2019, Mangione et al. 2023, Ryan et al. 2024) that were most interesting to us.

Results

To assess the reliability of the articles we used the PEDro Scale on each one. We got a total score of 6 which falls into the category of “good”.

Conclusion

It seems like there are some beneficial results with the multi-component home-based program, but it is not very significant compared to non-specific rehabilitation programs. However, despite these results based on our education, we believe that these programs are useful and should be taken into consideration when talking about a good quality of life for older adults. Overall, we think doing this project was advantageous for us because we got to experience working with research methods that some of us haven’t used before but will definitely be useful in the future. Also, it was a good way of getting familiar with evidence-based studies so we can start applying critical thinking in our professional practice.

Authors:

Linda Sněhotová, physiotherapy student, Charles University, Czech Republic

Anas Khida, physiotherapy student, Charles University, Czech Republic

Lucía Piastra, physiotherapy student, University of A Coruña, A Coruña, Spain

Álvaro Villar, physiotherapy student, University of A Coruña, A Coruña, Spain

Rebecca Petersen, physiotherapy student, Universidad Europea de Madrid, Spain

Dagmar Pavlu, Physiotherapist, Assoc. Prof. Charles University, Czech Republic

Ivana Vláčilová, Physiotherapist, PhD., Charles University, Czech Republic

Marja Äijö, PT, PhD Principal Lecturer of gerontology and rehabilitation, Savonia, University of Applied Sciences, Kuopio, Finland

Veronica Robles García, PhD. PT. OT. Lecturer, University of A Coruña, A Coruña, Spain

Beatriz Martínez Toledo, PT. Lecturer at University of A Coruña, A Coruña, Spain

Montserrat Fernández Pereira, PT, Lecturer at University of A Coruña, A Coruña, A Coruña, Spain

Lorena Canosa Carro, PT, MSc, PhD. Lecturer at Universidad Europea de Madrid, Spain

Adrien Pallot, PT, MSc, Lecturer at CEERRF, France

References

Mangione, K. K., Craik, R., Zhang, L. Q., & Magaziner, J. (2023). Effect of Multicomponent Home-Based Training on Gait and Muscle Strength in Older Adults After Hip Fracture Surgery: A Single Site Randomized Trial. Archives of physical medicine and rehabilitation, 104(2), 169–178. https://doi.org/10.1016/j.apmr.2022.08.974

Che, Y. J., Qian, Z., Chen, Q., Chang, R., Xie, X., & Hao, Y. F. (2023). Effects of rehabilitation therapy based on exercise prescription on motor function and complications after hip fracture surgery in elderly patients. BMC musculoskeletal disorders, 24(1), 817. https://doi.org/10.1186/s12891-023-06806-y

Magaziner, J., Mangione, K. K., Orwig, D., Baumgarten, M., Magder, L., Terrin, M., Fortinsky, R. H., Gruber-Baldini, A. L., Beamer, B. A., Tosteson, A. N. A., Kenny, A. M., Shardell, M., Binder, E. F., Koval, K., Resnick, B., Miller, R., Forman, S., McBride, R., & Craik, R. L. (2019). Effect of a Multicomponent Home-Based Physical Therapy Intervention on Ambulation After Hip Fracture in Older Adults: The CAP Randomized Clinical Trial. JAMA, 322(10), 946– 956. https://doi.org/10.1001/jama.2019.12964

Ryan, A. S., Beamer, B. A., Gruber-Baldini, A. L., Craik, R. L., Golden, J., Guralnik, J., Hochberg, M. C., Mangione, K. K., Orwig, D., Rathbun, A. M., & Magaziner, J. (2024). Effects of Multicomponent Home-Based Intervention on Muscle Composition, Fitness, and Bone Density After Hip Fracture. The journals of gerontology. Series A, Biological sciences and medical sciences, 79(5), glae078. https://doi.org/10.1093/gerona/glae078

Karlsson, Å., Lindelöf, N., Olofsson, B., Berggren, M., Gustafson, Y., Nordström, P., & Stenvall, M. (2020). Effects of Geriatric Interdisciplinary Home Rehabilitation on Independence in Activities of Daily Living in Older People With Hip Fracture: A Randomized Controlled Trial. Archives of physical medicine and rehabilitation, 101(4), 571–578. https://doi.org/10.1016/j.apmr.2019.12.007