SynthesisBMC geriatrics2026
Barriers and facilitators to rehabilitation exercise adherence in older adults with hip fractures: a mixed-methods systematic review.
Synthesis in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAs the global population faces a growing problem of aging, the prevalence of hip fractures in the older adults is increasing. Rehabilitation exercise was essential for recovering physical function and improving quality of life in older adults with hip fractures. However, older adults with hip fractures have lower rehabilitation exercise adherence, which can make it difficult for them to regain their pre-fracture physical function and mobility.
aimTo analyze the barriers and facilitators to rehabilitation exercise adherence in older adults with hip fractures.
methodsA systematic search of PubMed, Web of Science, Cochrane Library, EMBASE, and CINAHL for studies published from inception to March 30, 2025, with a language restriction of English. Screening of searched studies by two reviewers based on inclusion and exclusion. Data extraction was performed for the included studies, and methodological quality assessment was performed by the Mixed Methods Appraisal Tool (MMAT). The convergent integrated approach and thematic synthesis were used to synthesize and map extracted data to the Capability, Opportunity, Motivation-Behavior (COM-B) model.
resultsNineteen studies were included in this review, of 9 qualitative studies, 9 quantitative studies, and a mixed-methods study. The review analyzed 15 barriers, 10 facilitators, and an uncertain factor to rehabilitation exercise adherence in older adults with hip fractures. All factors were synthesized and categorized based on the COM-B model into physical capability, psychological capability, social opportunity, physical opportunity, reflective motivation, and automatic motivation.
conclusionBased on the COM-B model, this review examines various factors influencing to rehabilitation exercise adherence in older adults with hip fractures and may offer insights for enhancing adherence in clinical practice. Further refinement, evaluation, and validation of these factors are needed in future studies.
trial registrationThis review was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD420251019054).
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