Rehabilitation Strategies for Patients with Femoral Neck Fractures in Sarcopenia: A Narrative Review

Abstract

Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It has been identified as one of the most common comorbidities associated with femoral neck fracture (FNF). The aim of this review was to evaluate the impact of physical therapy on FNF patients’ function and rehabilitation. The selected articles were randomized controlled trials (RCTs), published in the last 10 years. Seven full texts were eligible for this review: three examined the impact of conventional rehabilitation and nutritional supplementation, three evaluated the effects of rehabilitation protocols compared to new methods and a study explored the intervention with erythropoietin (EPO) in sarcopenic patients with FNF and its potential effects on postoperative rehabilitation. Physical activity and dietary supplementation are the basic tools of prevention and rehabilitation of sarcopenia in elderly patients after hip surgery. The most effective physical therapy seems to be exercise of progressive resistance. Occupational therapy should be included in sarcopenic patients for its importance in cognitive rehabilitation. Erythropoietin and bisphosphonates could represent medical therapy resources.

Outpatient and Home-Based Treatment: Effective Settings for Hip Fracture Rehabilitation in Elderly Patients

“…Considering other studies, we highlight a review by Avola et al which also investigates the therapeutic effects of rehabilitation programs in femoral neck fractures [ 37 ]. However, the papers included in this review differ from ours because they focus on sarcopenia treatment rather than comparing different rehabilitation settings.…”

“…We adopted this approach to design our study’s rehabilitation program. However, that same review describes the potential advantage of antigravity treadmills, occupational therapy, protein-rich dietary supplementation, erythropoietin, bisphosphonates, calcium, and vitamin D [ 37 ]. Knowing the importance of bisphosphonates, calcium, and vitamin D supplementation, we described those as baseline characteristics of our sample.…”

A Narrative Review of Gut-Muscle Axis and Sarcopenia: The Potential Role of Gut Microbiota

“… 77 , 78 Calcifediol has a significant effect on improving muscle function in postmenopausal women. 79 The combined use of calcium and phosphate can significantly improve the muscle strength of patients with hip fractures. 80 The role of protein in sarcopenia will be discussed in the next section.…”

Molecular Regulation of Skeletal Muscle Growth and Organelle Biosynthesis: Practical Recommendations for Exercise Training

“…Skeletal muscles are essential for the maintenance of body’s integrity and health. Failure in muscle homeostasis leads to physiological integrity impairment, which contributes to chronic pathologies such as cachexia, metabolic and respiratory diseases, chronic inflammation, liver cirrhosis, and sarcopenia [ 1 , 2 , 3 , 4 , 5 , 6 ]. Muscle deficiency involves detrimental changes including deteriorations of cell metabolism and loss of muscle volume and strength, resulting in poor physical performance and quality of life [ 7 , 8 , 9 , 10 ].…”