Walking self-confidence and lower levels of anxiety are associated with meeting recommended levels of physical activity after hip fracture: a cross-sectional study

Kate E Noeske; David A Snowdon; Christina L Ekegren; Katherine E Harding; Luke A Prendergast; Casey L Peiris; Nora Shields; Paul D O'Halloran; Judi Porter; Jennifer J Watts; Nicholas F Taylor

doi:10.1080/09638288.2024.2338195

Walking self-confidence and lower levels of anxiety are associated with meeting recommended levels of physical activity after hip fracture: a cross-sectional study

Disabil Rehabil. 2024 Apr 18:1-7. doi: 10.1080/09638288.2024.2338195. Online ahead of print.

Authors

Kate E Noeske^{1

2}, David A Snowdon^{2

3

4

5}, Christina L Ekegren⁶, Katherine E Harding^{1

2}, Luke A Prendergast⁷, Casey L Peiris^{2

8}, Nora Shields⁹, Paul D O'Halloran¹⁰, Judi Porter¹¹, Jennifer J Watts¹², Nicholas F Taylor^{1

2}

Affiliations

¹ Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia.
² School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.
³ National Centre for Healthy Ageing (NCHA), Melbourne, Australia.
⁴ Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia.
⁵ Academic Unit, Peninsula Health, Melbourne, Australia.
⁶ Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
⁷ School of Computing, Engineering and Mathematical Sciences, La Trobe University, Bundoora, Australia.
⁸ The Royal Melbourne Hospital, Allied Health, Parkville, Australia.
⁹ Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Australia.
¹⁰ School of Psychology and Public Health, La Trobe University, Bundoora, Australia.
¹¹ Institute for Physical Activity and Nutrition (IPAN), Deakin University School of Exercise and Nutrition Sciences, Geelong, Australia.
¹² School of Health & Social Development, Faculty of Health, Deakin University, Burwood, Australia.

PMID: 38635302
DOI: 10.1080/09638288.2024.2338195

Abstract

Purpose: To explore whether psychological factors are associated with ability to meet recommended physical activity thresholds after hip fracture.

Materials and methods: Cross-sectional observational study of 216 community-dwelling adults aged ≥65 years after hip fracture (mean age 79 SD 7 years, 70% female). Multiple ordinal regression analysis determined factors associated with meeting physical activity thresholds related to positive health outcomes: 4,400 and 7,100 daily steps. Explanatory variables were: walking self-confidence; falls self-efficacy; depression; anxiety; co-morbidities; previous gait aid use; nutritional status; age; and gender.

Results: Forty-three participants (20%) met the lower threshold of ≥4,400 to <7,100 steps and thirty participants (14%) met the upper threshold of ≥7,100 steps. Walking self-confidence was positively associated with meeting higher physical activity thresholds (adjusted odds ratio [AOR] 1.32: 95% CI 1.11 to 1.57, p = 0.002). Age (AOR 0.93: 95% CI 0.89 to 0.98, p = 0.003), DASS-21 anxiety score (AOR 0.81: 95% CI 0.69 to 0.94, p = 0.008) and comorbidity index score (AOR 0.52: 95% CI 0.36 to 0.72, p < 0.001) were negatively associated with meeting higher physical activity thresholds.

Conclusion: Walking self-confidence and anxiety are potentially modifiable factors associated with meeting physical activity thresholds related to positive health outcomes after hip fracture.

Keywords: Hip fracture; exercise; older people; physical activity; rehabilitation; walking.

Plain language summary

Older people are often physically inactive after hip fracture, which can lead to negative health outcomes and increased risk of mortality.The potentially modifiable psychological factors of walking self-confidence and anxiety are associated with meeting recommended physical activity levels after hip fracture.Therapists should include assessment of psychological factors to help guide rehabilitation of patients after hip fracture.