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02.04.2019 | Original Article | Ausgabe 7/2019

Osteoporosis International 7/2019

Timeline of functional recovery after hip fracture in seniors aged 65 and older: a prospective observational analysis

Osteoporosis International > Ausgabe 7/2019
K. Fischer, M. Trombik, G. Freystätter, A. Egli, R. Theiler, H.A. Bischoff-Ferrari
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00198-019-04944-5) contains supplementary material, which is available to authorized users.
K. Fischer and M. Trombik are shared first authorship.

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We investigated the timeline of functional recovery after hip fracture over 12 months in adults age ≥ 65 years using objective lower extremity function tests and subjective physical functioning. Objective functional recovery was largely complete in the first 6 months, whereas subjective recovery improved up to 9 months after hip fracture.


Hip fractures are a major cause of loss of function among seniors. We assessed the timeline of objective and subjective functional recovery after hip fracture.


We conducted a prospective observational secondary analysis of a 1-year clinical trial on vitamin D and home exercise treatment and complications after hip fracture among 173 patients age ≥ 65 years (mean age 84 years; 79.2% women; 77.4% community-dwelling) conducted from January 2005 through December 2007. Lower extremity function (Timed Up and Go test (TUG), knee extensor and flexor strength) and grip strength was assessed at baseline and at 6 and 12 months follow-up. Subjective physical functioning was assessed using the SF-36 questionnaire also at 3 and 9 months follow-up. Multivariable-adjusted repeated-measures models were used to assess the timeline of functional recovery in the total population and in subgroups of patients.


Lower extremity function including TUG (− 61.1%), knee extensor (+ 17.6%), and knee flexor (+ 11.6%) strength improved significantly in the first 6 months (P < 0.001). However, between 6 and 12 months, there was no further significant improvement for any of the functional tests. Grip strength decreased from baseline to 6 months (− 7.9%; P < 0.001) and from 6 to 12 months (− 10.8%; P < 0.001). Subjective physical functioning improved from 3 to 9 months (+ 15.2%, P < 0.001), but no longer thereafter.


Functional recovery after hip fracture may be largely complete in the first 6 months for objective functional tests, whereas may extend up to 9 months for subjective recovery, with oldest-old, female, institutionalized, and cognitively impaired patients recovering most poorly.

Clinical trials registry (original trial)


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