Nakamura Keisuke, Sasaki Tomohiro, Kitagawa Takashi, Shimizu Masayuki, Aoki Kaoru
Department of Physical Therapy, School of Health Sciences, Shinshu University, Matsumoto, JPN.
Department of Rehabilitation, Matsumoto City Hospital, Matsumoto, JPN.
Cureus. 2025 Feb 17;17(2):e79133. doi: 10.7759/cureus.79133. eCollection 2025 Feb.
To investigate the effects of early mobilization on walking independence and gait recovery one year after hip fracture surgery.
This cohort study included 104 patients aged ≥65 years. Patients were divided into two groups: early mobilization (EM; postoperative mobilization on the day after surgery) and late mobilization (LM; postoperative mobilization ≥2 days after surgery) groups. Multivariate logistic regression analysis was performed to investigate the effect of EM on independent walking and recovery to pre-injury walking status one year postoperatively. Independent walking was defined as a walking functional independent measure (FIM) of ≥5.
The number of older patients able to walk independently at discharge and one year postoperatively after hip fracture surgery was 63 (60.6%) and 66 (63.5%), respectively. Multivariate logistic regression analysis revealed that EM was associated with independent walking at one year postoperatively (odds ratio, 3.79; 95% confidence interval, 1.30-11.06; P=0.001). However, EM was not associated with recovery to pre-injury walking status one year postoperatively (P=0.22).
Early postoperative mobilization significantly increased the likelihood of independent walking one year after hip fracture surgery in older adults. Patients who mobilized early were nearly four times more likely to achieve this outcome, underscoring the importance of EM in postoperative care. Further studies are needed to confirm these findings and address barriers to implementing EM in clinical practice.
探讨早期活动对髋部骨折手术后一年步行独立性和步态恢复的影响。
这项队列研究纳入了104名年龄≥65岁的患者。患者被分为两组：早期活动组（EM；术后第一天开始活动）和晚期活动组（LM；术后≥2天开始活动）。进行多因素逻辑回归分析，以研究早期活动对术后一年独立行走及恢复至伤前行走状态的影响。独立行走定义为步行功能独立性测量（FIM）≥5。
髋部骨折手术后出院时及术后一年能够独立行走的老年患者数量分别为63例（60.6%）和66例（63.5%）。多因素逻辑回归分析显示，早期活动与术后一年独立行走相关（比值比，3.79；95%置信区间，1.30 - 11.06；P = 0.001）。然而，早期活动与术后一年恢复至伤前行走状态无关（P = 0.22）。
术后早期活动显著增加了老年人髋部骨折手术后一年独立行走的可能性。早期活动的患者实现这一结果的可能性几乎是四倍，突出了早期活动在术后护理中的重要性。需要进一步研究来证实这些发现，并解决在临床实践中实施早期活动的障碍。
