ArticleClinical interventions in aging2025
An Evidence-Based Exercise Program for Total Hip Arthroplasty Rehabilitation in Geriatric Patients with Femoral Neck Fractures: A Delphi Study.
Article in Clinical interventions in aging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Femoral neck fractures (FNFs) represent a significant public health challenge in aging populations. Total hip arthroplasty (THA) has emerged as the preferred surgical management for active geriatric patients over 60 years old. However, standardized, evidence-based rehabilitation protocols specifically tailored to the Chinese healthcare context remain limited. Purpose: This study aimed to develop and validate an expert consensus-based exercise program for geriatric Chinese patients with FNFs undergoing THA, addressing gaps in pre-operative preparation, post-operative care, and home-based rehabilitation continuity. Patients and Methods: Using the Model for Evidence-Based Practice Change framework, we conducted a multi-phase study: (1) needs assessment through semi-structured interviews with 21 healthcare professionals; (2) systematic evidence synthesis from 16 high-quality sources; and (3) iterative refine the program through two-round Delphi consultation with 15 multidisciplinary experts from orthopedics, rehabilitation medicine, nursing, and management. Results: The Delphi process demonstrated high expert engagement (response rates: 93.75% round 1, 100% round 2) and acceptable authority (Cr=0.917). Expert coordination improved across rounds, with Kendall's W values increasing from 0.244-0.287 (round 1) to 0.104-0.371 (round 2) for different item levels, and coefficient of variation decreasing from 0.00-0.64 to 0.00-0.14. 11 items with CV>0.25 were eliminated after round 1, reflecting initial variability in expert opinions. The iterative consensus process yielded a four-domain program structure: (1) in-hospital pre-operative rehabilitation, (2) in-hospital post-operative rehabilitation, (3) out-of-hospital home-based rehabilitation, and (4) follow-up care. The final program comprises 4 first-level items, 17 second-level items, and 63 third-level items with specific operational parameters including timing, frequency, intensity, and methods adapted to Chinese clinical practice patterns. Conclusion: Through rigorous expert consensus methodology, this study developed a comprehensive, multi-level rehabilitation framework for geriatric FNFs patients undergoing THA in China, achieving acceptable agreement on program content and feasibility. As consensus-based findings, prospective validation is essential to establish clinical effectiveness and guide evidence-based implementation.
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