Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun;16(3):909-920.
doi: 10.1007/s41999-025-01205-z. Epub 2025 Apr 18.

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

Ruqayyah Y Turabi  1   2 , Matthew D L O'Connell  3 , David Wyatt  3 , Chris Bretherton  4 , Simon Cannon  5 , Celia L Gregson  6 , Iain Moppett  7 , Lynn McNicoll  8 , Katie Jane Sheehan  4
Affiliations

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

Ruqayyah Y Turabi et al. Eur Geriatr Med. 2025 Jun.

Abstract

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.

Keywords: International; Mobilization timing; Neck of femur fracture; Orthogeriatric; Rehabilitation; Weight-bearing.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: KS receives funding from UK Research & Innovation and the National Institutes of Health Research (NIHR) for hip fracture health services research not related to the current manuscript. KS is the Chair-elect of the Scientific Committee of the Fragility Fracture Network. DW has received NIHR funding that is unrelated to the current work. MOC has received NIHR funding that is unrelated to the current work. CG is funded by the NIHR (ref: NIHR302394). RT is sponsored for this PhD by Jazan University, which is affiliated with the Ministry of Education in Saudi Arabia. IM has/is in receipt of grant funding from NIHR, British Journal of Anaesthesia for hip fracture related research. He is a member of the NICE CG124 (hip fracture) group. LM, CB, and SC declare no conflict of interest. Ethical approval: This study received institutional ethical approval from King’s College London (MRSP-22/23-36307). Informed consent: Written informed consent was obtained before starting the survey. All provided written consent before starting. The survey was designed to be completely anonymous, with no identifying information collected from respondents.

Figures

Fig. 1
Fig. 1
Responses from 389 respondents across 71 countries
Fig. 2
Fig. 2
Response to ‘most frequent mobilisation timing prescription’ by country
Fig. 3
Fig. 3
Mobilisation practices overall and by World Bank Country Classification as high-income, or low- and middle-income. Grey represents the percentage of total responses, blue represents the percentage of responses from high-income countries, and orange represents the percentage of responses from low- and middle-income countries. A Timing of mobilisation. B The extent to which mobilisation on the day of or day after surgery is achieved.
Fig. 4
Fig. 4
Response to ‘most frequent weight-bearing prescription’ by country
Fig. 5
Fig. 5
Weight-bearing practices overall and by World Bank Country Classification as high-income, or low- and middle-income. Grey represents the percentage of total responses, blue represents the percentage of responses from high-income countries, and orange represents the percentage of responses from low- and middle-income countries. A Prescription of weight-bearing. B The extent to which unrestricted weight-bearing on the day of or day after surgery is achieved.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • Fragility Fracture Network Position on Unrestricted Weight-Bearing After Hip Fracture Surgery.
    Turabi R, Frihagen F, McGlasson R, Wyatt D, Trompeter A, Beaupre L, Cocco LF, Costa M, Dinamarca-Montecinos JL, Viveros-García JC, Lim JY, Lee JK, Khor HM, Ojeda-Thies C, Perracini M, Sawaguchi T, Switzer J, Tabu I, Yeung Wong RM, Mao W, Sheehan KJ. Turabi R, et al. Geriatr Orthop Surg Rehabil. 2025 Jul 1;16:21514593251351136. doi: 10.1177/21514593251351136. eCollection 2025. Geriatr Orthop Surg Rehabil. 2025. PMID: 40606571 Free PMC article.

References

    1. De Joode SG, Kalmet PH, Fiddelers AA, Poeze M, Blokhuis TJ (2019) Long-term functional outcome after a low-energy hip fracture in elderly patients. J orthop Traumatol 20:1–7. 10.1186/s10195-019-0529-z - PMC - PubMed
    1. Dyer SM, Crotty M, Fairhall N, Magaziner J, Beaupre LA, Cameron ID et al (2016) A critical review of the long-term disability outcomes following hip fracture. BMC Geriatr 16:158. 10.1186/s12877-016-0332-0 - PMC - PubMed
    1. Feng JN, Zhang CG, Li BH, Zhan SY, Wang SF, Song CL (2024) Global burden of hip fracture: the global burden of disease study. Osteoporos Int 35:41–52. 10.1007/s00198-023-06907-3 - PubMed
    1. Odén A, McCloskey EV, Kanis JA, Harvey NC, Johansson H (2015) Burden of high fracture probability worldwide: secular increases 2010–2040. Osteoporos Int 26:2243–2248. 10.1007/s00198-015-3154-6 - PubMed
    1. Sing CW, Lin TC, Bartholomew S, Bell JS, Bennett C, Beyene K et al (2023) Global epidemiology of hip fractures: secular trends in incidence rate, post-fracture treatment, and all-cause mortality. J Bone Miner Res 38:1064–1075. 10.1002/jbmr.4821 - PubMed

LinkOut - more resources