title: Walking recovery after a hip fracture: a prospective follow-up study among community-dwelling over 60-year old men and women.
abstract: OBJECTIVE
  Recovery of walking outdoors after hip fracture is important for equal participation in the community. The causes of poor recovery are not fully understood. This study investigates recovery of walking outdoors and associated determinants after hip fracture.
  
  
  METHODS
  A prospective follow-up study, among clinical sample of 81 community-dwelling hip fracture patients over 60 years. Perceived difficulty in walking outdoors and 500 meters was assessed before fracture, at discharge to home (3.2 ± 2.2 weeks after surgery), and on average 6.0 ± 3.3 weeks after discharge. Potential determinants for walking recovery were assessed. Linear latent trajectory model was used to analyse changes during follow-up. Association between walking trajectories and potential determinants was analysed with a logistic regression model.
  
  
  RESULTS
  Two trajectories, No-to-minor-difficulty and Catastrophic, were found. Thirty-eight percent of the participants ended up in the Catastrophic trajectory for walking outdoors and 67% for 500 meters. Multivariate logistic regression analysis revealed that use of walking aid and indoor falls before fracture and prolonged pain were independently associated with catastrophic decline in both primary outcomes: difficulty in walking outdoors and 500 meters.
  
  
  CONCLUSIONS
  A large proportion of community-dwelling older people recovering from hip fracture experienced catastrophic decline in outdoor walking. Acknowledging recovery prognoses at early stage enables individualized rehabilitation.
authors: Department of Health Sciences, Gerontology Research Center, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland.
authors: Anu
authors: A
authors: Salpakoski
authors: Department of Health Sciences, Gerontology Research Center, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland.
authors: Timo
authors: T
authors: Törmäkangas
authors: Department of Health Sciences, Gerontology Research Center, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland.
authors: Johanna
authors: J
authors: Edgren
authors: School of Health and Social Studies, University of Applied Sciences, Rajakatu 35, 40200 Jyväskylä, Finland.
authors: Sanna
authors: S
authors: Sihvonen
authors: Peurunka-Medical Rehabilitation and Physical Exercise Center, Peurungantie 85, 41340 Laukaa, Finland.
authors: Mika
authors: M
authors: Pekkonen
authors: Department of Health Sciences, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland.
authors: Ari
authors: A
authors: Heinonen
authors: Department of Orthopedics and Traumatology, Central Finland Central Hospital, Keskussairaalantie 19, 40620 Jyväskylä, Finland.
authors: Maija
authors: M
authors: Pesola
authors: Department of Medical Rehabilitation, Oulu University Hospital, P.O. Box 21, 90029 Oulu, Finland.
authors: Mauri
authors: M
authors: Kallinen
authors: Department of Health Sciences, Gerontology Research Center, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland.
authors: Taina
authors: T
authors: Rantanen
authors: Department of Health Sciences, Gerontology Research Center, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland.
authors: Sarianna
authors: S
authors: Sipilä
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000473:pathology / Q000534:rehabilitation* / Q000628:therapy; D006801:Humans; D008297:Male; D011379:Prognosis; D016138:Walking