ArticleAge and ageing2021
Orthopaedic physiotherapists' perceptions of mechanisms for observed variation in the implementation of physiotherapy practices in the early postoperative phase after hip fracture: a UK qualitative study.
Article in Age and ageing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Factors associated with concerns about falling and activity restriction in older adults after hip fracture: a mixed-methods systematic review.European geriatric medicine · 2024Pooled it
- Early Mobilization Compliance as a Quality Indicator After Hip Fracture Surgery: An Observational Study.Journal of clinical medicine · 2026Article
- Influences of Pre-fracture Mobility and Early Mobility on Healthcare Outcome Measures in Older Patients Undergoing Hip Fracture Surgery.Calcified tissue international · 2026Article
- Boosting inpatient exercise after hip fracture using an alternative workforce: a mixed methods implementation evaluation.BMC geriatrics · 2024Article
- What factors affect early mobilisation following hip fracture surgery: a scoping review.BMJ open quality · 2024Article
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- Using normalisation process theory for intervention development, implementation and refinement in musculoskeletal and orthopaedic interventions: a qualitative systematic review.Implementation science communications · 2023Review
- Physiotherapists' perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England.Age and ageing · 2023Article
- Orthopaedic Out of Bed Project (OOBP): improving early mobilisation following femoral fracture using a therapy-led education programme.BMJ open quality · 2023Article
- Development and Validation of Multivariable Prediction Models for In-Hospital Death, 30-Day Death, and Change in Residence After Hip Fracture Surgery and the "Stratify-Hip" Algorithm.The journals of gerontology. Series A, Biological sciences and medical sciences · 2023Article
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- The impact of the frequency, duration and type of physiotherapy on discharge after hip fracture surgery: a secondary analysis of UK national linked audit data.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Article
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Corrections and comments
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Authors and funding
15 authors at 10 institutions in 5 countries.
Funding
Abstract
objectiveto explore physiotherapists' perceptions of mechanisms to explain observed variation in early postoperative practice after hip fracture surgery demonstrated in a national audit.
methodsa qualitative semi-structured interview study of 21 physiotherapists working on orthopaedic wards at seven hospitals with different durations of physiotherapy during a recent audit. Thematic analysis of interviews drawing on Normalisation Process Theory to aid interpretation of findings.
resultsfour themes were identified: achieving protocolised and personalised care; patient and carer engagement; multidisciplinary team engagement across the care continuum and strategies for service improvement. Most expressed variation from protocol was legitimate when driven by what is deemed clinically appropriate for a given patient. This tailored approach was deemed essential to optimise patient and carer engagement. Participants reported inconsistent degrees of engagement from the multidisciplinary team attributing this to competing workload priorities, interpreting 'postoperative physiotherapy' as a single professional activity rather than a care delivery approach, plus lack of integration between hospital and community care. All participants recognised changes needed at both structural and process levels to improve their services.
conclusionphysiotherapists highlighted an inherent conflict between their intention to deliver protocolised care and allowing for an individual patient-tailored approach. This conflict has implications for how audit results should be interpreted, how future clinical guidelines are written and how physiotherapists are trained. Physiotherapists also described additional factors explaining variation in practice, which may be addressed through increased engagement of the multidisciplinary team and resources for additional staffing and advanced clinical roles.
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