gms | German Medical Science

Background: Regaining mobility, functionality and the ability to care for oneself after a proximal femur fracture is of great importance for older adults to stay independent. A correlation between physical activity during hospitalization and preoperative functionality and mobility and the ability to perform activities of daily living at the time of discharge has been reported. However, it was not reported which aspects of physical activity are particularly relevant.

Aim: The aim of the study is to explore, which physical activities are particularly relevant to optimize mobility outcomes throughout a hospital stay due to a proximal femur fracture.

Methods: A total of 48 patients with proximal femur fractures are to be recruited at the Geriatric Traumatology Center at Oldenburg Hospital shortly after surgical treatment. A sensor (ActivPAL) will be used to record physical activity after surgery. In addition, physical activity before the start of hospitalization will be assessed retrospectively using a questionnaire (German PAQ 50+). Mobility parameters are collected at the beginning and end of the inpatient stay using the De Morton Mobility Index (DEMMI). The data are presented descriptively.

Results: To date, 11 patients (2 male, 9 female, 80.6 ±5.6 years) have been included in the study. The ActiPAL was placed on average 2 days after surgery (min-max: 1–4 days). The median raw DEMMI score increased from 3 (1–4) at admission to 12 (6–12) at discharge. The median energy expenditure assessed with the German PAQ 50+ was 4870 kcal·week-1 (455–11890 kcal·week-1). The median daily number of steps increased from 16 (0–124) on day 2 to 36 (0–1958) on day 7. The median time spent standing increased from 7.0 min (1.7–29.2 min) on day 2 to 26.3 min (0–116.3 min) on day 7. The median number of transfers from lying to sitting or standing per day increased from 7 (1–17) on day 2 to 15 (0–49) on day 7.

Implication for research and/or (healthcare) practice: The descriptive results show that patients with proximal femur fractures improve their mobility over the course of treatment. Nevertheless, despite the efforts of multimodal therapy, the activity level is low. In future, a regression analysis will be used to identify the physical activity parameters that seem to result in the greatest improvement in mobility. In the future, more targeted recommendations for physical activity during the hospital stay should improve the mobility of older people with proximal femur fractures upon discharge, and increase their post-inpatient quality of life.