Physical Therapy and Mobility 2 and 6 Months After Hip Fracture

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Abstract
Objectives: To examine the relationship between early physical therapy (PT), later therapy, and mobility 2 and 6 months after hip fracture. Design: Prospective, multisite observational study. Setting: Four hospitals in the New York City area. Participants: Four hundred forty‐three hospitalized older patients discharged after surgery for hip fracture in 1997–98. Measurements: Patient demographics, fracture type, comorbidities, dementia, number of new impairments at discharge, amount of PT between day of surgery and postoperative day (POD) 3, amount of therapy between POD4 and 8 weeks later, and prefracture, 2‐, and 6‐month mobility measured using the Functional Independence Measure. Results: More PT immediately after hip fracture surgery was associated with significantly better locomotion 2 months later. Each additional session from the day of surgery through POD3 was associated with an increase of 0.4 points (P=.032) on the 14‐point locomotion scale, but the positive relationship between early PT and mobility was attenuated by 6 months postfracture. There was no association between later therapy and 2‐ or 6‐month mobility. Conclusion: PT immediately after hip fracture surgery is beneficial. The effects of later therapy on mobility were difficult to assess because of limitations of the data. Well‐designed randomized, controlled trials of the effect of varying schedules and amounts of therapy on functional status after hip fracture would be informative.