Very low levels of physical activity among patients hospitalized following hip fracture surgery: a prospective cohort study

Disabil Rehabil. 2025 Jan 21:1-10. doi: 10.1080/09638288.2025.2451769. Online ahead of print.

Abstract

Purpose: The evidence supports early and intensive mobilization and physical activity for patients who are hospitalized following hip fracture. The objectives were to determine levels of physical activity among patients hospitalized following hip fracture surgery, and to explore the association between levels of physical activity and 30-day post-discharge readmission, and mortality.

Materials and methods: We collected data at two university hospitals in Denmark from March-June 2023. Patients were included on postoperative day (POD) 1 to 3. 24-h upright time was measured from inclusion to discharge using a thigh-worn accelerometer. 30-day readmission and mortality were verified by patient records.

Results: 101 patients with a mean (SD) age of 79.9(8.4) years were included. The median (IQR) 24-h upright time on POD2-6 ranged from 15(7:31) to a maximum of 34(16:67) mins. Within 30 days after discharge, 25 patients(25%) were readmitted or referred to an emergency ward and 3(3%) patients died (no clear association with upright time).

Conclusions: For patients hospitalized following hip-fracture surgery, the level of physical activity seems extremely low the first week, but it does not seem to influence the rate of readmissions. Considering evidence supporting physical activity during acute hospitalization, the low activity level in these patients calls for action.

Clinicaltrials.gov-identifier: NCT05756517.

Keywords: Hip fracture; hospitalization; physical activity; recovery; rehabilitation; upright time.

Plain language summary

Early and intensive mobilization is crucial for improving outcomes in patients hospitalized following hip fracture surgery.This study shows low levels of physical activity during acute hospitalization after hip fracture surgery, underscoring the need for targeted interventions to ensure in-hospital activity and improve patient recovery outcomes.Multidisciplinary collaboration is essential to address barriers to physical activity during acute hospitalization and thereby enhance physical activity levels.Rehabilitation professionals should prioritize strategies to support patients with cognitive impairments, who are at risk of lower activity levels during hospitalization.Physical activity levels during hospitalization were not associated with 30-day readmission.

Associated data

  • ClinicalTrials.gov/NCT05756517