Introduction: Older adults often experience incomplete recovery after a hip fracture. Rehabilitation programs with progressive resistance training are associated with improved functional recovery. This systematic review and meta-analysis with meta-regression a) evaluated resistance training characteristics reported in hip fracture rehabilitation programs, b) performed meta-analysis of resistance training impact on strength (primary outcome), gait and physical activity (secondary outcomes), and c) explored resistance training program characteristics associated with improved outcomes using meta-regression. Materials and Methods: Medline, EMBASE, CINAHLPLUS, and Web of Science Core Collection databases were searched (January2000–February2021). Randomized controlled trials including progressive resistance training rehabilitation programs after hip fracture surgery in adults ≥50 years old were included. Meta-analyses and exploratory meta-regression were performed. Results: Meta-analysis showed significant increases in strength (10 trials-728 participants; Standardized Mean Difference (SMD) [95%CI]; .40 [.02, .78]) immediately following program completion in intervention relative to control participants. Meta-analysis on 5 trials (n = 384) with extended follow up found no significant group differences (SMD = .47 [-.28, 1.23]) in strength. Center-based relative to home-based programs were associated with significantly greater improvements in strength (P < .05) as were programs where resistance training intensity was prescribed using one-repetition maximum relative to other exercise prescription methods (P < .05). In gait meta-analysis (n = 10 trials-704 participants), gait speed in intervention participants immediately after the program was significantly higher than control (SMD = .42 [.08, .76]) but this finding was not maintained in extended follow-up (n = 5 trials-240 participants; SMD = .6 [-.26, .38]). Higher resistance training intensity was associated with significant improvements in gait speed (P < .05). No meta-analysis was performed for the 3 heterogeneous studies reporting physical activity. Discussion: Progressive resistance training improved muscle strength and gait speed after hip fracture surgery in adults ≥50years old immediately after the program ended, but the longer-term impact may be more limited. Conclusions: Higher resistance training intensity and center-based programs may be associated with more improvement, but require further research.

简介：老年人在髋部骨折后通常会经历不完全恢复。渐进式阻力训练的康复计划与改善功能恢复有关。该系统回顾和荟萃分析采用荟萃回归 a) 评估了髋部骨折康复计划中报告的阻力训练特征，b) 对阻力训练对力量（主要结果）、步态和身体活动（次要结果）的影响进行了荟萃分析， c) 使用元回归探索与改善结果相关的阻力训练计划特征。材料和方法：检索了 Medline、EMBASE、CINAHLPLUS 和 Web of Science 核心合集数据库（2000 年 1 月至 2021 年 2 月）。纳入了随机对照试验，包括 50 岁以上成人髋部骨折手术后进行性阻力训练康复计划。进行了荟萃分析和探索性荟萃回归。结果：Meta 分析显示，相对于对照参与者，在干预计划完成后立即强度显着增加（10 项试验，728 名参与者；标准化平均差 (SMD) [95%CI]；0.40 [.02, .78]）。对 5 项试验 (n = 384) 进行了长期随访的荟萃分析发现，强度没有显着的组间差异 (SMD = .47 [-.28, 1.23])。以中心为基础的计划相对于以家庭为基础的计划与力量的显着改善相关（P < .05），与其他运动处方方法相比，使用一次重复最大值规定阻力训练强度的计划也是如此（P< .05)。在步态荟萃分析（n = 10 项试验-704 名参与者）中，干预参与者的步态速度在项目结束后立即显着高于对照组（SMD = .42 [.08, .76]），但这一发现在扩展后并未保持随访（n = 5 次试验 - 240 名参与者；SMD = .6 [-.26, .38]）。更高的阻力训练强度与步态速度的显着改善相关（P < .05）。没有对报告身体活动的 3 项异质研究进行荟萃分析。讨论：渐进式阻力训练在计划结束后立即改善了≥50 岁成人髋部骨折手术后的肌肉力量和步态速度，但长期影响可能更有限。结论：更高的阻力训练强度和以中心为基础的计划可能与更多的改进有关，但需要进一步研究。