No rest for the wounded: early ambulation after hip surgery accelerates recovery

ANZ J Surg. 2006 Jul;76(7):607-11. doi: 10.1111/j.1445-2197.2006.03786.x.


Background: Level 3 evidence-based guidelines recommend first walk after hip fracture surgery within 48 h. Early mobilization is resource and effort intensive and needs rigorous investigation to justify implementation. This study uses a prospective randomized method to investigate the effect of early ambulation (EA) after hip fracture surgery on patient and hospital outcomes.

Methods: Sixty patients (41 women and 19 men; mean age 79.4 years) admitted between March 2004 through December 2004 to The Alfred Hospital, Melbourne, for surgical management of a hip fracture were studied. Randomization was either EA (first walk postoperative day 1 or 2) or delayed ambulation (DA) (first walk postoperative day 3 or 4). Functional levels on day 7 post-surgery, acute hospital length of stay and destination at discharge were compared.

Results: At 1 week post-surgery, patients in the EA group walked further than those in the DA group (P = 0.03) and required less assistance to transfer (P = 0.009) and negotiate a step (P = 0.23). Patients in the EA group were more likely to be discharged directly home from the acute care than those in the DA group (26.3 compared with 2.4%) and less likely to need high-level care (36.8 compared with 56%). A failed early ambulation subgroup had significantly more postoperative cardiovascular instability and worse results for all outcome measures.

Conclusion: EA after hip fracture surgery accelerates functional recovery and is associated with more discharges directly home and less to high-level care.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Hip Fractures / physiopathology
  • Hip Fractures / rehabilitation*
  • Hip Fractures / surgery
  • Hip Joint / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods*
  • Physical Therapy Modalities*
  • Range of Motion, Articular / physiology
  • Recovery of Function / physiology*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Walking / physiology*