Abstract
Purpose: This exploratory study aimed to describe the extent to which mobilisation timing and weight- bearing after hip fracture surgery vary globally and between high-income countries (HICs) and low- and middle-income countries (LMICs) and identify the possible reasons for this variation.
Methods: This international cross-sectional study was delivered via an online, English-language, self-administered questionnaire. Healthcare professionals from diverse multidisciplinary teams were invited to participate through professional organisations, including the Fragility Fracture Network, social media, and by snowballing from key stakeholders.
Results: In total, 389 healthcare professionals responded from across 71 countries. 72.5% reported prescribing mobilisation on the day after surgery, with a higher proportion in HICs (79.1%) than LMICs (56.3%). Where early mobilisation was prescribed, 38.3% reported achieving this 76-100% of the time, more often in HICs (42.9%) than LMICs (21.9%). Overall, 73.5% reported prescribing unrestricted weight-bearing, more often in HICs (86.3%) than LMICs (41%). Where unrestricted weight- bearing was prescribed, 50.4% reported achieving this 76-100% of the time, with a higher proportion in HICs (54.0%) than LMICs (31.9%). Multiple patient-related, process-related, and structure-related barriers were reported, with structure-related barriers more common in LMICs than HICs, underscoring the global complexities in implementing these practices.
Conclusion: This study is the first to offer insights into global variations in the timing of mobilisation and weight-bearing after hip fracture surgery in older adults. It demonstrates disparities between HICs and LMICs in postoperative services and resources. It lays the groundwork for future studies and highlights the importance of international collaboration and knowledge exchange in improving postoperative care services.
Methods: This international cross-sectional study was delivered via an online, English-language, self-administered questionnaire. Healthcare professionals from diverse multidisciplinary teams were invited to participate through professional organisations, including the Fragility Fracture Network, social media, and by snowballing from key stakeholders.
Results: In total, 389 healthcare professionals responded from across 71 countries. 72.5% reported prescribing mobilisation on the day after surgery, with a higher proportion in HICs (79.1%) than LMICs (56.3%). Where early mobilisation was prescribed, 38.3% reported achieving this 76-100% of the time, more often in HICs (42.9%) than LMICs (21.9%). Overall, 73.5% reported prescribing unrestricted weight-bearing, more often in HICs (86.3%) than LMICs (41%). Where unrestricted weight- bearing was prescribed, 50.4% reported achieving this 76-100% of the time, with a higher proportion in HICs (54.0%) than LMICs (31.9%). Multiple patient-related, process-related, and structure-related barriers were reported, with structure-related barriers more common in LMICs than HICs, underscoring the global complexities in implementing these practices.
Conclusion: This study is the first to offer insights into global variations in the timing of mobilisation and weight-bearing after hip fracture surgery in older adults. It demonstrates disparities between HICs and LMICs in postoperative services and resources. It lays the groundwork for future studies and highlights the importance of international collaboration and knowledge exchange in improving postoperative care services.
| Original language | English |
|---|---|
| Title of host publication | INTERNATIONAL JOURNAL OF PHYSICAL THERAPY RESEARCH & PRACTICE |
| Publication status | Published - Nov 2024 |