Abstract：
This study determines the effectiveness of exercise rehabilitation interventions on depressive symptoms in older adults after hip fracture. Ovid MEDLINE, Embase, Global Health, APAPsych, CENTRAL, CIHAHL, PEDro and Open Grey were searched from database inception to June 10, 2022 for definitive, pilot or feasibility randomised controlled trials of rehabilitation interventions (versus any comparator) which reported depressive symptoms among older adults post hip fracture. Nonrandomised trials and those not published in English were excluded. Selection, quality appraisal (Cochrane Risk of Bias 2) and extraction in duplicate. Results were synthesised narratively and with meta-analysis (Hedge\'s g for intervention effect, I2 for heterogeneity). Eight trials (1146 participants) were included. Interventions were predominantly face-to-face exercise rehabilitation (range three to 56 sessions) at home versus usual care. Three trials were assigned overall low risk of bias, three some concerns and two high risk. The pooled effect of rehabilitation on depressive symptoms at intervention end favoured the intervention group (Hedges\'s g -0.43; 95% CI: -0.87, 0.01; four trials). Three trials demonstrated no between group difference following adjustment for baseline depressive symptoms. One trial found lower odds of depression when the intervention additionally included falls prevention, nutrition consultation and depression management. There is a potential benefit of exercise rehabilitation interventions on depressive symptoms after hip fracture. A mechanism for benefit may relate to baseline symptom severity, exercise frequency, frequency of health professional contacts, addition of a psychological component or of the quality of the underlying trials. To appropriately inform clinical guidelines, further appropriately powered trials with follow-up are warranted. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: CRD42022342099.
摘要：
这项研究确定了运动康复干预对老年人髋部骨折后抑郁症状的有效性。OvidMEDLINE,Embase,全球卫生,APAPsych,中部,CIHAHL,从数据库开始到2022年6月10日，对PEDro和OpenGrey进行了搜索，康复干预的试点或可行性随机对照试验(与任何比较者相比)报告了老年人髋部骨折后的抑郁症状。非随机试验和非英文发表的试验被排除。选择,质量评估(Cochrane偏差风险2)和提取一式两份。结果以叙述方式和荟萃分析进行综合(对冲干预效果，I2表示异质性)。纳入了8项试验（1146名参与者）。与常规护理相比，干预措施主要是在家中进行面对面的运动康复（范围为3至56次）。三项试验的偏倚风险总体较低，三个问题和两个高风险。干预结束时康复对抑郁症状的综合影响有利于干预组(Hedges/sg-0.43;95%CI:-0.87,0.01;四项试验)。三项试验表明，在调整基线抑郁症状后，组间没有差异。一项试验发现，当干预措施还包括预防跌倒时，抑郁的几率较低，营养咨询和抑郁症管理。运动康复干预对髋部骨折后的抑郁症状具有潜在的益处。受益机制可能与基线症状严重程度有关，锻炼频率,健康专业接触的频率，增加心理因素或基础试验的质量。为了适当地告知临床指南，有必要进行进一步的适当有力试验和随访.审判注册：ClinicalTrials.gov标识符：CRD42022342099。
