Article

PURPOSE: To find out how much physical activity in the form of walking can be
tolerated by adults admitted for inpatient rehabilitation after hip fracture.
METHOD: Using a phase I dose-response design, in addition to usual scheduled
rehabilitation care participants without cognitive impairment were supervised to
walk for a prescribed length of time on 5 consecutive days. Doses started at 3
min and were escalated when three participants successfully completed a dose.
Secondary outcomes included physical activity and the Ambulatory Self-Confidence
Questionnaire (ASCQ). RESULTS: The maximum tolerated dose of walking for the 13
participants (4 men and 9 women; mean age 81 years, SD 10) was 6 min. At 10 min
only 1 of 5 participants was able to complete the dose. The main reason for not
tolerating the prescribed dose was fatigue. Participants had relatively low
levels of daily physical activity (mean 507 steps/day), and lacked confidence in
their walking (ASCQ mean 4.6). CONCLUSION: Physical activity guidelines for older
people are not appropriate for patients in active inpatient rehabilitation
recovering from hip fracture where other factors such as fatigue may limit
physical activity levels. These results can be taken into account when designing
rehabilitation programmes after hip fracture. Implications for Rehabilitation Hip
fracture is a common and serious fracture with ongoing disability for which
people require inpatient rehabilitation to prepare for return to independent
living in the community. The maximum tolerated dose of walking of 6 minutes
suggests physical activity guidelines for older people are not applicable for
those receiving active inpatient rehabilitation after hip fracture. The maximum
tolerated dose of walking of 6 minutes during inpatient rehabilitation suggests
rehabilitation programmes be structured to allow adequate time for recovery.

Langue : ANGLAIS