A Cochrane review [Abstract] 1 on the effects of multidisciplinary rehabilitation for older patients with hip fracture included 13 trials with a total of 2 498 older, usually female, patients who had undergone hip fracture surgery. Multidisciplinary rehabilitation was provided primarily in an inpatient setting in 11 trials. Pooled results showed no statistically significant difference between intervention and control groups for poor outcome (risk ratio 0.89; 95% CI 0.78-1.01), mortality (risk ratio 0.90, 95% CI 0.76-1.07) or hospital readmission. Individual trials found better results, often short-term only, in the intervention group for activities of daily living and mobility. The trial comparing primarily home-based multidisciplinary rehabilitation with usual inpatient care found marginally improved function and a clinically significantly lower burden for carers in the intervention group. Participants of this group had shorter hospital stays, but longer periods of rehabilitation. One trial found no significant effect from doubling the number of weekly contacts at the patient's home from a multidisciplinary rehabilitation team.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in study populations, interventions and outcomes) and by limitations in study quality.
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