The effect of early mobilization on functional outcomes after hip surgery in the Chinese population - A multicenter prospective cohort study.

Abstract

To compare the functional status and quality of life (QoL) between patients who underwent an early mobilization scheme and those who underwent a late mobilization scheme after hip fracture fixation surgery in elderly Chinese patients. This was a prospective cohort study. Patients (≥65years old) with unstable intertrochanteric fractures treated with intramedullary nails were recruited from nine centers in China. Study centers either performed early mobilization or late mobilization scheme. All patients performed immediate in-bed mobilization after surgery and followed a standardized daily exercise program at home during the first 12weeks. Functional status was measured by the Modified Barthel Index at postoperative visit, 6weeks, and 12weeks. QoL was measured by the EuroQol-5D (EQ-5D) at 12weeks. One hundred and forty-eight patients were enrolled to early mobilization, and 136 to late mobilization. At 6weeks, early mobilization resulted in a significantly better Modified Barthel Index than late mobilization (mean [SD]: 83.7 [12.0] vs. 67.0 [17.5], p < .001). Adjusted mixed effects model showed significantly higher Modified Barthel Index for early mobilization at postoperative visit, 6weeks, and 12weeks (all p < .001). Patients in the early mobilization group had slightly better EQ-5D Index at 12weeks than patients in the late mobilization group (mean: 0.91 vs 0.87, p = .002). Early postoperative mobilization resulted in better functional outcomes up to 12weeks. QoL was rated statistically significantly better in the early mobilization group, but the difference was small and may not be clinically relevant.