Rehabilitation interventions for older adults with a hip fracture and cognitive impairment: Systematic review
Bibliographic record
Abstract
Introduction: A hip fracture in older adulthood can result in function and mobility decline. The consequences are debilitating and place a great burden on patients, caregivers, and the healthcare system. Although inpatient rehabilitation programs have proven effective, the best practices required to maintain the gains in function and mobility, and to enable this population to continue living at home, are currently unknown. Purpose: To identify and assess the effectiveness of outpatient rehabilitation interventions provided to older adults with a cognitive impairment (CI) that have been discharged from acute care or in-patient rehabilitation following hip fracture surgery. Methods: The methods outlined in the Cochrane Handbook for Systematic Reviews of Intervention were followed and findings were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they had participants who underwent hip fracture surgery, and had any form of CI; and conducted an outpatient intervention that takes place in the home or community. Two reviewers independently performed data extraction and assessed the methodological quality of each article. Findings were synthesized to determine which components of the identified outpatient interventions were the most beneficial to this patient population. Results: The original search resulted in over three thousand articles. Four studies, two of which used the same data pool, satisfied the necessary criteria to be included in the systematic review. All studies included inpatient and outpatient physiotherapy, with some including a cognitive component, family education, and a discharge assessment. All studies were reported as successful. Conclusion: Findings provide support for the necessity of community driven rehabilitation options for this population to remain independent. These findings will be used to inform the development of a multi-faceted home-based outpatient rehabilitation program aimed at enabling older adults remain living at home after a hip fracture.Acknowledgments: Technology Evaluation in the Elderly
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.044 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.008 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".