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Older Adults' Sedentary Behavior and Physical Activity After Hip Fracture

Results From an Outpatient Rehabilitation Randomized Controlled Trial

Zusman, Enav Z., MSc1,2; Dawes, Martin, MD, PhD2; Fleig, Lena, PhD3; McAllister, Megan M., BSc, MPT1,2; Cook, Wendy L., MD4,5; Guy, Pierre, MD1,6; Brasher, Penelope M. A., PhD7; McKay, Heather A., PhD1,2,6; Khan, Karim M., MD, PhD1,2,8; Ashe, Maureen C., PhD1,2

Journal of Geriatric Physical Therapy: April/June 2019 - Volume 42 - Issue 2 - p E32–E38
doi: 10.1519/JPT.0000000000000193
Research Reports

Background and Purpose: Prolonged sedentary time and limited physical activity can result in deleterious effects on health and mobility, especially for older adults with fall-related hip fracture. Therefore, the purpose of this study was to examine the effect of a multidisciplinary clinic on sedentary behavior and physical activity (prespecified secondary outcomes) and provide descriptions of activity patterns over 1 year for men and women.

Methods: We conducted a parallel-group, single-blinded randomized controlled trial comparing a multidisciplinary clinic and usual care (intervention) with usual care (control). We recruited 53 community-dwelling older adults aged 65+ years who were 3 to 12 months postfracture and collected data at baseline, 6, and 12 months; study staff were blinded to group allocation. The clinic included a geriatric assessment by the geriatrician, physiotherapist, and occupational therapist. Referrals were made to other professionals, when indicated. We collected the accelerometer-measured sedentary behavior and physical activity at 3 time points. We used linear mixed-effects models to compare groups at 6 and 12 months and mixed models to compare outcomes between men and women.

Results: Participants were sedentary for more than 10 hours of a 13-hour day, and there were no significant differences between the study groups at 6 months (2.4 [95% confidence interval: −22.4 to 27.2] minutes) or 12 months (−3.7 [95% confidence interval: −33.6 to 26.1] minutes). Compared with women, men spent 47.2 min/d more in sedentary time (P = .052) and 43.8 min/d less in light physical activity (P = .047).

Discussion: Older adults after hip fracture spend prolonged periods of waking hours sedentary with very little activity.

1Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, Canada.

2Department of Family Practice, The University of British Columbia, Vancouver, Canada.

3Health Psychology/Social, Organizational and Economic Psychology, Freie Universität Berlin, Berlin, Germany.

4Division of Geriatric Medicine, Department of Medicine, The University of British Columbia, Vancouver, Canada.

5Providence Healthcare, Toronto, Ontario, Canada.

6Department of Orthopaedics, The University of British Columbia, Vancouver, Canada.

7Centre for Clinical Epidemiology and Evaluation, Vancouver, British Columbia, Canada.

8School of Kinesiology, The University of British Columbia, Vancouver, Canada.

Address correspondence to: Maureen C. Ashe, PhD, Centre for Hip Health and Mobility, The University of British Columbia, 7F—2635 Laurel St, Vancouver, V5Z 1M9, Canada (

The authors thank their study participants for their contribution to this project. This study was funded by the Canadian Institutes of Health Research (CIHR) grant (FRN 99051) and career award support for Dr. Ashe from CIHR, the Michael Smith Foundation for Health Research, and the Canada Research Chairs Program.

The authors declare they have no conflict of interest to disclose.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Richard Bohannon was the Decision Editor.

© 2019 Academy of Geriatric Physical Therapy, APTA
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