Globally, one in three women and one in five men over fifty will suffer a hip fracture. These statistics make hip fractures and their repercussions a public health concern. The financial burden on the system is increasing with Canada’s aging population. Post-acute rehabilitation minimizes the strain of follow-up care for both individuals and the health care system. Inadequate rehabilitation leads to rises in subsequent fractures, health expenses, and mortality. Currently there is no standardized model of post-acute care for hip fractures. The existing literature presents numerous potential models to improve care practices and can help answer this national and global issue.

Research shows that exercise is a fundamental aspect of hip fracture rehabilitation. However, the environment and intensity to optimize the benefits of exercise have not been clearly established. Without clear criteria, post-acute care conventions are inconsistent and not widely accessible. In America, inconsistent practices have resulted in inequities in the healthcare system. Similar trends are likely seen in Canada as national guidelines outline the value of active rehabilitation but does not offer a standard best practice model.

A major variable in the quality of post-acute treatment is the environment of care. Providing post-acute rehabilitation to inpatient stable patients is seen as an inefficient use of hospital resources. Alternative care routes such as rehabilitation facilities are not widely accessible due to financial barriers. The pressure to discharge can push patients to compromise their quality of care. This is highlighted as inpatients and those admitted to rehabilitation facilities have lower mortality rates than those discharged to the community and could be explained by access to care services. In the community, the Canadian National Hip Fracture Toolkit recommends attending ongoing exercise programs offered locally. While such programs may be effective, various mobility barriers can prevent use. Further accessibility limitations are created when resource demands restrict the availability of programs in rural areas. Home-based programs reduce financial, mobility, and geographic barriers bringing the benefits of exercise to those in need. Home-based exercise programs have the potential to reduce hospital utilization and minimize barriers that compromise care. To date, no systematic reviews have identified the best practice models for the effectiveness of home-based exercise programs. This paper will evaluate studies that implemented home-based exercise programs identifying their impact on rehabilitation. According to the literature how effective are home-based exercise programs at improving physical function in patient 60 + recovering from a hip fracture?