Early Mobilization Within 48 Hours as a Determinant of Functional Independence After Hip Fracture Surgery: Evidence From a Cohort Study.

Background  Postoperative mobilization is an important aspect of rehabilitation after hip fracture surgery among older adults. However, the optimal timing of mobilization remains disputed. This study compared early and delayed postoperative mobilization and their associations with short-term functional outcomes. Methods  We conducted an ambispective observational cohort study of 405 older patients (aged 60 years or older) who had undergone hip fracture surgery. Participants were divided into two groups based on the timing of their first assisted mobilization: early mobilization (≤48 hours) and delayed mobilization (>48 hours). The New Mobility Score (NMS) was used to assess functional mobility at baseline (based on pre-fracture recall) and four weeks postoperatively. At four weeks, functional independence was assessed using the Barthel Index (BI). We used the Mann-Whitney U test to compare the groups and ordinal logistic regression to assess predictors of functional independence at four weeks. Results  Early mobilization was significantly associated with higher baseline and follow-up NMS scores and higher BI scores at four weeks (p < 0.001). Age and BMI were significantly negatively associated with BI scores (p < 0.001). Regression analysis showed that early mobilization, younger age, lower BMI, fewer comorbidities, better pre-fracture mobility, less dependence on assistive devices, type of surgery, and shorter time to surgery were independently associated with greater functional independence (p < 0.05). In contrast, gender was not significantly associated with functional outcomes. Conclusion  Early mobilization within 48 hours after hip fracture surgery was strongly associated with greater mobility and functional independence at four weeks in older patients.