The impact of early mobility on functional recovery after hip fracture surgery

Abstract

Purpose

To examine the effect of early mobility (EM) on functional recovery after hip fracture surgery, and to investigate the potential factors that delay mobility.

Methods

In this retrospective observational study, 110 hip fracture patients were divided into two groups according to the days between surgery and mobility referred to as the EM and the delayed mobility groups. Demographic data, perioperative data, functional outcomes, and discharge destination were compared statistically between the groups using univariate analysis and logistic regression analysis. As a sensitivity analysis, the factors associated with the timing of physiotherapy were also assessed.

Results

The EM group had significantly better walking ability and Barthel index (p < 0.05), and home discharge rate (p = 0.004). The factors associated with delayed mobility (odds ratio; 95% confidence interval) were delayed postoperative physiotherapy initiation (3.59; 1.76–7.33), days from admission to surgery (1.23; 1.04–1.46), and postoperative CRP (1.14; 1.01–1.29) and hemoglobin level (0.72; 0.54–0.96). Furthermore, patients who received surgery on the day before any holiday were significantly delayed in physiotherapy intervention (p = 0.006).

Conclusions

This study demonstrated that EM after hip fracture surgery was associated with improving functional recovery and home discharge rate, and early physiotherapy intervention was associated with EM.

Implications for Rehabilitation

• Early mobility on the first day after hip fracture surgery was associated with improving walking ability and independence of daily activities on postoperative days 7 and 14, as well as on the time to discharge to own home.

• Early mobility was specifically associated with the timing of physiotherapy intervention, the days from admission to surgery and the medical condition including perioperative anemia. In particular, patients who received surgery on the day before any holiday were significantly delayed in physiotherapy intervention.

Keywords:

• Hip fracture
• early mobility
• rehabilitation
• physiotherapy
• functional recovery

Acknowledgements

We also thank physical therapists Yohei Maeda, Fumiya Naonaga, and Keita Tanaka to assess functional outcomes and collect data.

Ethics statement

This retrospective observational study was performed at St. Luke’s International Hospital, Tokyo, Japan, and was approved by institutional review board of St. Luke’s International University, Tokyo, Japan (19-R032).

Consent form

Informed consent was obtained in the form of opt-out on the web-site.

Disclosure statement

The authors declared no conflicts of interest.