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Identifying Key Balance Skills Predicting Functional Independence After Hip Fracture: A Decision Tree Analysis of
Hiroaki Yoshida1,2, Yasuhide Nakayama3, Kenji Higuchi1
1Department of Rehabilitation Medicine, The Jikei University School of Medicine Kashiwa Hospital, Japan.
Geriatric Orthopaedic Surgery & Rehabilitation
|December 12, 2025
Summary
Specific balance exercises like 360° turning and sit-to-stand can help hip fracture patients regain independence. Targeted rehabilitation focusing on these skills improves mobility and quality of life for older adults.
Area of Science:
- Geriatric Medicine
- Rehabilitation Science
- Orthopedics
Background:
- Hip fractures significantly impair mobility and independence in older adults.
- Berg Balance Scale (BBS) sub-items can predict functional outcomes post-fracture.
Purpose of the Study:
- Identify critical balance skills differentiating activity levels after hip fracture.
- Utilize BBS sub-items to predict functional recovery.
Main Methods:
- Retrospective analysis of 252 older adults with hip fractures.
- Classification into Independent, House-bound, and Chair-bound groups.
- Decision tree analysis using BBS sub-items as predictors.
Main Results:
- 360° Turning and Sit to Stand distinguished Independent from House-bound.
- "Reaching Forward While Standing" and "Standing Unsupported" distinguished House-bound from Chair-bound.
- Model accuracy reached 81.9% and 83.3% for the respective classifications.
Conclusions:
- Specific balance skills are key predictors of functional status post-hip fracture.
- Tailoring rehabilitation based on these skills can improve patient outcomes.
- Enhanced functional recovery can improve quality of life for older adults.
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