Conclusion : Based on available evidence , older adults with hip fracture engage in prolonged sedentary behavior and have low levels of physical activity during rehabilitation and recovery
Objective : To synthesize evidence on older adults ’  sedentary behavior and physical activity during rehabilitation and recovery for hip fracture ( 1 ) across the care continuum and ( 2 ) from clinical interventions .
HIP4Hips (High Intensity Physiotherapy for Hip fractures in the acute hospital setting): a randomised controlled trial.
OBJECTIVES To investigate the effects of intensive acute hospital physiotherapy for patients with isolated hip fractures . DESIGN , SETTING Single-institution , prospect i ve , r and omised trial at a level 1 trauma centre in Melbourne , March 2014 - January 2015 . PARTICIPANTS 92 patients aged 65 years or more with isolated hip fractures . Patients were excluded if the fracture was subtrochanteric or pathological , or if post-operative orders required the patient to be non-weight-bearing on the operated leg . INTERVENTIONS R and omisation to usual care physiotherapy ( daily ; control group ) or intensive physiotherapy ( three times daily ; intervention group ) . MAIN OUTCOME MEASURES Outcomes were assessed at post-operative Day 5 , at discharge , and at 6 months . The primary outcome was the modified Iowa Level of Assistance ( mILOA ) score , with other outcome measures including Timed Up and Go test performance and hospital length of stay ( LOS ) . RESULTS After controlling for sex , anaesthetic type and home setting , the between-group difference in Day 5 mILOA score favoured the intervention group ( mean difference v control group , -2.7 points ; P = 0.04 ) . Hospital LOS was also shorter for the intervention group ( median , 24.4 days v 35.0 days ; P = 0.01 ) . A Cox proportional hazard model that controlled for potential confounders indicated that the probability of discharge was greater for intervention group patients at all time points following surgery ( P < 0.001 ) . Re-admission and complication rates and 6-month outcomes for the two groups were not significantly different . CONCLUSIONS Intensive acute hospital physiotherapy is safe and reduces hospital LOS after an isolated hip fracture . This has the potential to improve bed flow , given the large numbers of inpatient beds occupied by this patient population . TRIAL REGISTRATION Clinical Trials Registry # NCT02088437
Conclusion : Based on available evidence , older adults with hip fracture engage in prolonged sedentary behavior and have low levels of physical activity during rehabilitation and recovery
Objective : To synthesize evidence on older adults ’  sedentary behavior and physical activity during rehabilitation and recovery for hip fracture ( 1 ) across the care continuum and ( 2 ) from clinical interventions .