Factors associated with concerns about falling and activity restriction in older adults after hip fracture

Factors associated with concerns about falling and activity restriction in older adults after hip fracture

Key actions aiming at improving concerns about falling and activity restriction after hip fracture include: improve physical and functional abilities; boost self-confidence; promote positive affect; involve relatives and carers; increase access to clinicians, and enhance accessibility of the home, outdoors and transport.


Recovery after a hip fracture requires adequate physical capabilities and confidence about balance. Most hip fracture patients report concerns about falling in the first three months after their fracture, though. This systematic review synthesized the quantitative and qualitative evidence on factors of concerns about falling and activity restriction after hip fracture surgery in the community.


The following factors were identified based on the results of the 19 studies of the review:
• Physical factors included falls history, comorbidities, balance, strength, mobility and functionality. 
• Psychological factors included anxiety and neuroticism scores, perceived confidence in/control over rehabilitation and abilities, and negative/positive affect about the orthopaedic trauma, pre-fracture abilities and future needs. 
• Environmental factors included accessibility in the home, outdoors and with transport. 
• Social and care factors related to the presence or absence of formal and informal networks, which reduced concerns and promoted activity by providing feedback, advice, encouragement, and practical support.


According to the authors: ‘Future interventions should seek to target the factors identified by the current review that predispose an individual to concerns about falling post-fracture’. 

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