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Exercise, nutrition and managing hip fracture in older persons.

Current opinion in clinical nutrition and metabolic care
January 1, 2014
Maria A Fiatarone Singh
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the role of calcium, alongside other nutrients and exercise, in improving outcomes after hip fracture.

Results Summary

Calcium supplementation, often combined with vitamin D, showed improvements in biochemical indices and mobility, but isolated nutritional interventions did not consistently impact long-term outcomes after hip fracture.

Population

Individuals recovering from hip fracture, likely older adults.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (19)
InterventionDirectionEndpointPopulationDosageImpactClaim #
isolated resistance training
increase
muscle strength
-
-
associated with greater clinical benefits
#1
isolated resistance training
increase
mobility
-
-
associated with greater clinical benefits
#2
isolated resistance training
increase
function
-
-
associated with greater clinical benefits
#3
multimodal home-based programs
increase
muscle strength
-
-
associated with greater clinical benefits
#4
multimodal home-based programs
increase
mobility
-
-
associated with greater clinical benefits
#5
multimodal home-based programs
increase
function
-
-
associated with greater clinical benefits
#6
multinutrient supplements
increase
body weight
-
-
improvements
#7
multinutrient supplements
increase
biochemical indices
-
-
improvements
#8
multinutrient supplements
decrease
complication rates
-
-
improvements
#9
multinutrient supplements
increase
mobility
-
-
improvements
#10
nutritional counseling and support
increase
body weight
-
-
improvements
#11
nutritional counseling and support
increase
biochemical indices
-
-
improvements
#12
nutritional counseling and support
decrease
complication rates
-
-
improvements
#13
nutritional counseling and support
increase
mobility
-
-
improvements
#14
vitamin D/calcium supplementation
increase
body weight
-
-
improvements
#15
vitamin D/calcium supplementation
increase
biochemical indices
-
-
improvements
#16
vitamin D/calcium supplementation
decrease
complication rates
-
-
improvements
#17
vitamin D/calcium supplementation
increase
mobility
-
-
improvements
#18
isolated nutritional interventions
no change
long-term outcomes after hip fracture
-
-
not consistently shown significant impact
#19
Abstract

PURPOSE OF REVIEW: Lifestyle factors play a role in both the genesis and recovery from fragility fracture. The purpose of this review is to summarize recent evidence for exercise and nutrition in the management of hip fracture. RECENT FINDINGS: Recent randomized controlled trials of exercise have primarily consisted of isolated resistance training or multimodal home-based programs. More robust, long-term, or supervised training is generally associated with greater clinical benefits, including muscle strength, mobility, and function. Recent nutritional interventions have included multinutrient supplements, nutritional counseling and support, and vitamin D/calcium supplementation. Isolated nutritional interventions have not consistently shown significant impact on long-term outcomes after hip fracture, although improvements in body weight, biochemical indices, complication rates, and mobility have been reported. Overall, there is marked heterogeneity in the robustness of responses seen to hip fracture treatment studies. Few large, long-term, multicomponent interventions with clinically relevant outcomes of functional independence, need for residential care, mortality, and quality of life have been reported. SUMMARY: Evidence-based approaches to hip fracture should include comprehensive risk-factor assessment and treatment for sarcopenia/dynapenia, balance impairment, undernutrition of protein, energy, vitamin D and calcium, depression, cognitive impairment, sensory impairment, social isolation, and comorbid illness with exercise, nutrition and other modalities.

Medical Subject Headings (MeSH)
Body WeightBone and BonesCalcium, DietaryDietary ProteinsDietary SupplementsEvidence-Based MedicineExerciseHip FracturesHumansLife StyleMalnutritionNeuropsychologyNutritional StatusRandomized Controlled Trials as TopicRisk FactorsSarcopeniaVitamin DVitamin K
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality75/10
Citation Metrics
Total Citations37
Citations/Year3.4
Relative Citation Ratio1.91
NIH Percentile73.2%
Research Impact Scores
APT Score0.75
Weight Score1.64
Normalized Score0.61
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