Trajectory of physical activity after hip fracture: An analysis of community-dwelling individuals from the English Longitudinal Study of Ageing

Injury. 2018 Mar;49(3):697-701. doi: 10.1016/j.injury.2018.02.010. Epub 2018 Feb 10.

Abstract

Introduction: To analyse physical activity participation in a community-dwelling people in England with hip fracture the interval prior to fracture, in the fracture recovery period, and a minimum of two years post-fracture.

Materials and methods: 215 individuals were identified from the English Longitudinal Study of Ageing cohort (2002-2014) who sustained a hip fracture following a fall and for whom data were available on physical activity participation relating to the period pre-fracture, within-fracture recovery phase and post-fracture (minimum of two years). Physical activity was assessed using the validated ELSA physical activity questionnaire. Prevalence of 'low' physical activity participation was calculated and multi-level modelling analyses were performed to explore physical activity trajectories over the follow-up phase, and whether age, depression, gender and frailty were associated with physical activity participation.

Results: Prevalence of low physical activity participation within two years prior to hip fracture was 16.7% (95% Confidence Intervals (CI): 11.6% to 21.8%). This increased at the final follow-up phase to 21.3% (95% CI: 15.1% to 27.6%). This was not a statistically significant change (P = 0.100). Age (P = 0.005) and frailty (P < 0.001) were statistically significant explanatory variables (P = 0.005) where older age and greater frailty equated to lower physical activity participation. Neither gender (P = 0.288) nor depression (P = 0.121) were significant explanatory variables.

Conclusion: Physical activity levels do not significantly change between pre-fracture to a minimum of two years post-hip fracture for community-dwelling individuals. This contrasts with previous reports of reduced mobility post-hip fracture, suggesting that 'physical activity' and 'mobility' should be considered as separate outcomes in this population.

Keywords: Community-dwelling; Femur; Fracture; Longitudinal; Physical activity; Recovery.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging*
  • Biomechanical Phenomena
  • Disability Evaluation
  • England
  • Exercise*
  • Female
  • Fracture Fixation, Internal
  • Health Surveys
  • Hip Fractures / physiopathology
  • Hip Fractures / rehabilitation*
  • Hip Fractures / surgery
  • Humans
  • Independent Living
  • Longitudinal Studies
  • Male
  • Mobility Limitation*
  • Postoperative Period
  • Recovery of Function
  • Time Factors