Very low levels of physical activity among a broad group of patients hospitalized following hip fracture: A prospective cohort study (the HIP-ME-UP cohort study)

Objectives The evidence supports early and intensive mobilization and physical activity for hospitalized patients following a hip fracture. Since bedrest and inactivity during acute care are potentially fatal, we need updated knowledge of levels of physical activity in a diverse clinical population. Therefore, the objective was to determine levels of physical activity among a broad representation of patients hospitalized following hip fracture, and secondly to explore the association with 30-day post-discharge readmission, and mortality. Design Prospective cohort study Setting Data were collected at two university hospitals in the Capital Region of Denmark from March to June 2023. Participants Patients hospitalized following hip fracture. Main outcome measures 24-hr upright time (time standing and walking) was measured from inclusion (post-operative day (POD) 1-3) to discharge using a thigh-worn accelerometer. Readmission and mortality were verified by electronic patient records. Results 101 patients (62 women) with a mean (SD) age of 79.9 (8.4) years were included. The median (IQR) 24-hr upright time on POD2-6 ranged from 15 (6.9:31.0) to a maximum of 34 (16:67) mins. Patients with cognitive impairment had less upright time than patients without. Post-surgery length of stay was a median of 7 (5:8) days. 25% of the patients were readmitted or had emergency ward referrals and 3% died within 30 days of discharge (no clear association with upright time). Conclusions Physical activity seems extremely low among a broad representation of patients within the first week following a hip fracture but was not found to influence readmissions. Considering the strong evidence supporting physical activity during acute hospitalization, the low activity level in these patients calls for action. [Clinicaltrials.gov][1]-identifier : [NCT05756517][2] ### Competing Interest Statement There was no declaration of interest in the form of financial competition or personal relationships that could have appeared to influence the work reported in this paper. For possible competing interest, see conflict of interest statements from all authors. ### Funding Statement The authors have received grants from the Association of Danish Physiotherapists and the Reseach Fund of Copenhagen University Hospital, Amager and Hvidovre, Hvidovre, Denmark. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Approval was obtained (Journal-nr.: F-22060655) by the Ethics Committee of the Capital Region of Denmark, and from the Danish Data Protection Agency (P-2023-94). The study adhered to the principles of the Helsinki Declaration. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data used in current study might be available (will be assessed individually) from the corresponding author on reasonable request. [1]: http://Clinicaltrials.gov [2]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT05756517&atom=%2Fmedrxiv%2Fearly%2F2024%2F02%2F12%2F2024.02.09.24302483.atom