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The impact of cognitive impairment on rehabilitation outcomes in elderly patients admitted with a femoral neck fracture: a systematic review
Muir SW, Yohannes AM.. Journal of geriatric physical therapy (2001), 2009-01-01
Topic: Risk, prevention and care in population studies
Objective To evaluate the evidence of rehabilitation outcomes after the surgical repair of a hip fracture in older people with cognitive impairment. Design Systematic review. Methods Searches were conducted in MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library (Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness, and Cochrane Controlled Trials Register), ProQuest Dissertations, and Theses Database and bibliographies of extracted publications in the English language between 1990 and June 2007. Search terms included: dementia/Alzheimer disease/cognitive impairment, hip fracture, rehabilitation, outcome assessment/treatment outcome. Two independent reviewers undertook screening and methodological quality assessment, using the Downs and Black rating scale, of the extracted articles. Only studies evaluating rehabilitation outcomes with data analysis specific for cognitive status were evaluated. Sackett's levels of evidence were used to summarize the main findings. Findings Eleven studies met the inclusion criteria. Methodological quality of the studies ranged from fair to poor. The generalizability of study findings was limited by multiple rehabilitation settings in the acute and subacute phase postsurgery, multiple methods with varying thresholds for determining cognitive impairment and multiple functional outcome scales. Conclusion There is some evidence that older adults with cognitive impairment who receive intensive inpatient rehabilitation after surgical repair of a hip fracture may be able to gain comparable benefit in physical function as cognitively intact patients. There is not enough information to guide recommendations of specific physical therapy interventions to optimize outcomes in this patient population. Further work is needed.
Key findings
- Findings Eleven studies met the inclusion criteria.
- Methodological quality of the studies ranged from fair to poor.
- The generalizability of study findings was limited by multiple rehabilitation settings in the acute and subacute phase postsurgery, multiple methods with varying thresholds for determining cognitive impairment and multiple functional outcome scales.
- Conclusion There is some evidence that older adults with cognitive impairment who receive intensive inpatient rehabilitation after surgical repair of a hip fracture may be able to gain comparable benefit in physical function as cognitively intact patients.
- There is not enough information to guide recommendations of specific physical therapy interventions to optimize outcomes in this patient population.
Why it matters
This systematic review found only some evidence that older adults with cognitive impairment who receive intensive inpatient rehabilitation after hip fracture surgery may benefit. The included studies were of fair to poor quality, so the findings are limited and cannot be considered definitive.
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Study details
- Study designsystematic review
- Evidence strengthHigh
How this study scored 53/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of geriatric physical therapy (2001)) |
| Journal's citation record | 0 / 4 | Journal of Geriatric Physical Therapy: journal h-index 67 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2009 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 5 / 7 | Cited 102 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.4 citations a year over 19 year(s) since 2009 |
| Impact for its field and year | 3 / 6 | Cited 4.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 11 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Abebaw Mengistu Yohannes: h-index 43 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Western University: institution h-index 899 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 19856633) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 53 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Muir, S. W., & Yohannes, A. M. (2009). The impact of cognitive impairment on rehabilitation outcomes in elderly patients admitted with a femoral neck fracture: a systematic review. Journal of geriatric physical therapy (2001). https://doi.org/10.1519/00139143-200932010-00006
Vancouver
Muir SW, Yohannes AM. The impact of cognitive impairment on rehabilitation outcomes in elderly patients admitted with a femoral neck fracture: a systematic review. Journal of geriatric physical therapy (2001). 2009. doi:10.1519/00139143-200932010-00006. PMID: 19856633.
BibTeX
@article{muir2009-19856633,
author = {Muir, S. W. and Yohannes, A. M.},
title = {{The impact of cognitive impairment on rehabilitation outcomes in elderly patients admitted with a femoral neck fracture: a systematic review}},
journal = {Journal of geriatric physical therapy (2001)},
year = {2009},
doi = {10.1519/00139143-200932010-00006},
pmid = {19856633},
url = {https://doi.org/10.1519/00139143-200932010-00006}
}
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