Background The main focus of rehabilitation following hip fracture is to regain mobility. Objectives To estimate the progression of real-world mobility the first year after hip fracture using digital mobility outcomes. Design An exploratory, prospective cohort study with pooled data from four previously conducted clinical trials. Setting and Subjects We combined data from the Trondheim Hip Fracture Trial and Eva-Hip Trial in Trondheim, Norway, and the PROFinD 1 and PROFinD 2 trials in Stuttgart and Heidelberg, Germany, resulting in a sample of 717 hip fracture patients aged ≥65 years. Methods Each of the trials assessed mobility using body-fixed sensors (activPAL) at three time points, collectively providing observations across the entire first year post-surgery. The following 24-h DMOs were calculated: total walking duration (minutes), maximum number of steps within a walking bout, and number of sit-to-stand-to-walk transfers. Continuous 1-year progression of the median, the 25th percentile, and the 75th percentile were estimated using quantile regression models with splines. Results The dataset contained 5909 observation days. The median daily total walking duration increased until 36 weeks post-surgery reaching 40 min; daily maximum number of steps within a walking bout increased during the first eight weeks and then stabilized at less than 100 steps; daily sit-to-stand-to-walk transfers reached a plateau after 6 weeks with less than 40 transfers. Conclusions The three DMOs progressed differently and attained plateau levels at varying times during the first year after hip fracture, indicating that these Digital Mobility Outcomes provide complementary information about different aspects of mobility recovery.

中文翻译：

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髋部骨折后真实世界活动能力恢复：四项随机对照试验数字活动结果的二次分析


背景 髋部骨折后康复的主要重点是恢复活动能力。目的 使用数字移动性结果估计髋部骨折后第一年真实世界移动性的进展。设计 一项探索性的前瞻性队列研究，汇集了来自先前进行的四项临床试验的数据。环境和受试者 我们结合了挪威特隆赫姆的特隆赫姆髋部骨折试验和 Eva-Hip 试验的数据，以及德国斯图加特和海德堡的 PROFinD 1 和 PROFinD 2 试验的数据，得出 717 名年龄在 ≥65 岁的髋部骨折患者的样本。方法 每项试验都在三个时间点使用身体固定传感器 （activPAL） 评估活动能力，共同提供术后整个第一年的观察结果。计算以下 24 小时 DMO：总步行持续时间（分钟）、步行期间的最大步数以及从坐到站再到步行的转移次数。使用带有样条的分位数回归模型估计中位数、第 25 个百分位数和第 75 个百分位数的连续 1 年进展。结果 数据集包含 5909 个观察日。中位每日总步行时间增加至术后 36 周达到 40 分钟;在前 8 周内，步行中的每日最大步数增加，然后稳定在 100 步以下;每日坐姿到站姿再到行走的转移在 6 周后达到平台期，转移次数少于 40 次。结论 在髋部骨折后的第一年，这三种 DMO 的进展不同，并在不同时间达到平台水平，表明这些数字移动性结果提供了有关移动性恢复不同方面的补充信息。