Exploring Older Adults' Patterns and Perceptions of Exercise after Hip Fracture

Abstract

This study highlights the responses of a group of older adults recovering well after hip fracture. Older adults engage in exercise despite the potential limitations associated with a hip fracture. Participants' responses underscore the importance of intrinsic factors and suggest avenues for future investigation.

Patient Perspectives on Engagement in Recovery after Hip Fracture: A Qualitative Study

“…Consistent with previous research, the most commonly reported barriers by study participants for engaging in physical activity were pain from complications during recovery [21, 25], lack of information on what they could physically do without hindering their recovery [26], and low motivation or acceptance of their changed level of functional ability [25, 27]. Intrapersonal, psychosocial factors (e.g., positive attitudes, optimism, expectations, motivation, self-efficacy, and outcome experience) and the reception of social support from family, friends, and health care providers can also play an important facilitating role in recovery [12, 21].…”

“…This issue is compounded by a lack of information provided to patients [19], either as a result of limited resources or a lack of understanding of what is needed by patients for recovery or lack of patient engagement (or some combination). As demonstrated in our results misinformation can further exacerbate disengagement from one's recovery [20, 21]. Providing patients with a more realistic timeline for their recovery has its difficulties given the heterogeneity of those experiencing hip fracture.…”

“…Engaging in physical activity was discussed by participants, who emphasized the importance of rehabilitation services, such as physiotherapy, in not only teaching patients what exercises they can do to improve their functional outcomes, but also in motivating them to keep up with their exercises if progress is not initially realized. One participant in our study described the advice of her physician to simply walk more after she asked about participating in physiotherapy; however, exercises prescribed by physiotherapists can better utilize the movements required to perform daily life activities and, as such, better prepare patients to return to these activities than solely walking [21]. …”

“…Intrapersonal, psychosocial factors (e.g., positive attitudes, optimism, expectations, motivation, self-efficacy, and outcome experience) and the reception of social support from family, friends, and health care providers can also play an important facilitating role in recovery [12, 21]. …”

“…Studies show that improvements in patients' level of self-efficacy can effectively increase adherence to exercise activities and improve functional outcomes [8, 29–31], particularly in the first 6 months after surgical intervention [32, 33]. Adherence further increases when exercise is integrated into patients' daily routines [21], and improvements to ambulation and functional ability begin to be realized [21, 28]. Besides self-efficacy, attributing progress in recovery to one's own efforts (e.g., through continued engagement in activity)/having an internal locus of control has been associated with greater independence in performing activities of daily living and lower levels of disability [34].…”