Weight-bearing and mobilisation timing after hip fracture surgery in older adults: an international survey of clinicians' perspectives.

PURPOSE: This exploratory study aimed to describe international variations in mobilisation timing and weight-bearing after hip fracture surgery, focusing on differences between high-income countries (HICs) and low- and middle-income countries (LMICs) and identify the possible reasons for these variations.

METHODS

This international cross-sectional study was administered through an online, English-language, self-reported questionnaire. Healthcare professionals from various multidisciplinary teams were invited to participate via professional organisations, including the Fragility Fracture Network, social media, and through snowballing from key individual stakeholders.

RESULTS

A total of 389 healthcare professionals from 71 countries participated in the survey. Among them, 72.5% prescribed mobilisation the day after surgery, higher in HICs (79.1%) than LMICs (56.3%). Of those who prescribed early mobilisation, 38.3% achieved it 76-100% of the time, more frequently in HICs (42.9%) than LMICs (21.9%). Additionally, 73.5% prescribed unrestricted weight-bearing, also more common in HICs (86.3%) than LMICs (41%). For those who prescribed unrestricted weight-bearing, 50.4% achieved it 76-100% of the time, with HICs at 54.0% and LMICs at 31.9%. Multiple patient-related, process-related, and structure-related barriers were reported, with structure-related barriers more common in LMICs than HICs, underscoring the global complexities in implementing these practices.

CONCLUSION

This study offers insights into global variations in the timing of mobilisation and weight-bearing after hip fracture surgery in older adults. It reveals disparities in postoperative services and resources between HICs and LMICs. Additionally, it establishes a foundation for future research and underscores the importance of international collaboration and knowledge sharing in enhancing postoperative care services.