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Objective measurement of sedentary behaviour and physical activity in older adults after hip fracture : results from a randomised controlled trial Zusman, Enav Zipora


Introduction: Hip fracture is a serious event with longstanding implications for older adults. These fractures frequently lead to reduced mobility, prolonged periods of sitting time, and consequently, a lack of physical activity. Objectives: I aimed to test how a comprehensive geriatric management clinic affects sedentary behaviour and physical activity patterns over a 12-month period, and to characterise the recovery patterns of sedentary behaviour and physical activity for older adults after hip fracture. Methods: This study collected prospective objective measurements (accelerometry) of sedentary behaviour and physical activity patterns from older adults with hip fracture. I described and tested sedentary behaviour and physical activity using accelerometry at baseline, 6 and 12 months from a parallel-group, 1:1 single-blinded randomised controlled trial for older adults 3-12 months after hip fracture. The usual care group received standard post-operative management; the intervention group received usual care plus a clinical management by health professionals. Results: The study enrolled 53 participants [mean age (SD) 79(8) years], 3-12 months post-fracture. Forty-five participants had valid data (intervention (n=22) or usual care (n=23) group). Participants had a mean (SD) age of 79.2 (7.4) years, ranged 65-98 years, with a median (p10, p90) of 203 (143, 335) days since fracture. Participants from both groups spent approximately 10 hours/day in sedentary behaviour. There were no statistically significant differences between groups for sedentary behaviour or physical activity variables at midpoint and final assessment. Men engaged in significantly more sedentary time (47 minutes; p=0.049), and spent less time in light physical activity (44 minutes; p=0.044) compared with women, across the study. Although men had more sedentary time at each time point, the difference was attenuated at final assessment and was no longer statistically significant. Conclusion: Older adults after hip fracture spend prolonged periods of waking hours sedentary and without much activity. Decreasing and breaking up sedentary time and increasing physical activity is an important target for rehabilitation. Differences between sexes should be acknowledged and addressed by health professionals. Further, strategies should be developed and tested to reduce time spent in sedentary behaviour and increase physical activity for older adults after hip fracture.

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