Source:Archives of Physical Medicine and Rehabilitation
Author(s): Casey Peiris, Nora Shields, Michael Kingsley, Jack Yeung, Raphael Hau, Nicholas Taylor
ObjectiveTo determine how much moderate-intensity physical activity, in the form of walking, could be prescribed for people living in the community after hip fracture in terms of safety, tolerability and feasibility.DesignPhase I dose-response design.SettingParticipants were recruited from two public community rehabilitation centres in Melbourne, Australia.ParticipantsCommunity-dwelling adults (n=21, 16 women, mean age ± SD, 75 ± 9 years) who were cognitively alert, attending community rehabilitation after a hip fracture (mean ± SD days post fracture, 110 ± 47 days), able to walk with or without a gait aid and for whom it was safe to participate in physical activity.InterventionIndividually supervised doses of moderate intensity walking completed in one week in addition to their usual levels of physical activity. Three participants were required to complete a dose of walking prior to dose escalation for the next cohort of three participants. Dose escalation ceased when more than one participant in a cohort had an adverse event or was unable to tolerate the dose or if the maximum dose of 150 minutes per week was achieved.Main Outcome MeasuresMaximum tolerated dose of walking per week (minutes), adverse events, mobility and walking confidence.ResultsThe maximum tolerated dose of walking for adults after hip fracture before significant discomfort was experienced (e.g. breathlessness, pain, fatigue) by any participant was 100 minutes per week. No adverse events occurred but participants began to be unable to tolerate higher doses beyond 100 minutes per week.ConclusionsThis provides preliminary evidence that community-dwelling older adults recovering from hip fracture can complete a sufficient amount of moderate intensity physical activity to maintain and improve their health.
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