Improving walking after hip fracture
MIHip: Motivational Interviewing to Improve Walking After Hip Fracture
Hip fractures are a major public health issue affecting more than 23,000 Australians each year. They result in significant mortality and morbidity for older adults and are characterised by poor outcomes. One in five patients with hip fracture dies within 12 months, one in three patients do not return to living independently in the community, and one in two patients have markedly reduced levels of walking.
Patients with hip fracture are relatively inactive during rehabilitation and remain inactive after discharge home. Our work has shown that people recovering from a hip fracture do not lack the physical capacity to walk in their community, but rather lack the confidence to do so. Current rehabilitation protocols focus on the physical capacity to walk and do not address this issue.
Motivational interviewing is an intervention that has a specific focus on increasing confidence for behaviour change. In a pilot trial, we found eight weekly telephone sessions of motivational interviewing resulted in participants with hip fracture having an immediate increase in their walking and confidence about walking. The MIHip trial will determine if the positive results found in our pilot study are maintained in a randomised attention placebo controlled trial of 270 participants with 12-month follow-up. We will also be conducting a full health economic analysis.
Patients receiving outpatient rehabilitation at Eastern Health and Peninsula Health following a hip fracture from September 2019 are being invited to participate in the trial, which is due to be completed in 2022.