Increasing mobility in hospital after hip fracture

Area of Science:

• Orthopedics
• Geriatric Medicine
• Rehabilitation Medicine

Background:

• Hip fractures are a major health concern in the UK, affecting 70,000 individuals annually and costing £4.3 billion.
• A significant percentage (30%) of hip fracture patients do not return to their usual residence within 120 days post-surgery.
• Current rehabilitation guidelines recommend limited physiotherapy (2 hours/week), despite evidence suggesting more intensive therapy could improve recovery.

Purpose of the Study:

• To evaluate the effectiveness of increased physiotherapy duration and frequency, alongside mobility-focused strategies, for hip fracture patients.
• To determine if enhanced rehabilitation protocols lead to improved patient outcomes, including return to pre-injury residence.
• To assess the impact of intensified rehabilitation on hospital discharge timing and patient recovery trajectories.

Main Methods:

• A two-arm, multicentre, cluster randomized controlled trial (RCT) named World Hip Trauma Evaluation (WHiTE) 15: INITIATE.
• One arm receives routine care, while the other receives routine care plus increased physiotherapy and mobility interventions.
• Embedded process and economic evaluations are included to assess implementation and cost-effectiveness.

Main Results:

• Data collection is ongoing; results are pending.
• The study aims to provide robust evidence on the benefits of enhanced physiotherapy for hip fracture recovery.
• Analysis will focus on patient discharge destinations, recovery speed, and functional outcomes.

Conclusions:

• The findings will inform potential updates to national rehabilitation guidelines for hip fracture patients.
• This research seeks to establish optimal physiotherapy protocols for improving patient mobility and independence post-surgery.
• The study will contribute valuable data on the cost-effectiveness of intensified rehabilitation interventions.