Community ambulation after hip fracture: completing tasks to enable access to common community venues

Purpose: This observational study explored the ability of people who had returned home after hip fracture to complete specified walking tasks reflective of community ambulation. Method: Walking distances, pedestrian crossing times, kerbs, stairs and slopes were measured at 70 sites in a metropolitan area. From these, five walking tasks were developed and 22 people who had received rehabilitation after hip fracture attempted these tasks. Participants also completed the Ambulatory Self-Confidence Questionnaire (ASCQ) and London Handicap Scale. Results: Most participants (18/22) were able to complete walking tasks reflective of walking in the community. However, half of the participants self-reported significant mobility restriction on the London Handicap Scale and variable levels of confidence (ASCQ mean 6.5 SD 1.4) when walking in their community. Conclusions: People living in their communities after hip fracture were able to complete walking tasks reflective of community ambulation but reported a lack of confidence in their walking ability and significant self-perceived participation restriction. These results suggest that more emphasis could be placed on strategies to increase patient confidence when completing rehabilitation after hip fracture in order to allow successful integration back to their community.Implications for RehabilitationWalking tasks designed in this study may provide clinicians with valuable information about what physical measures are required for walking in the community.Focusing rehabilitation on physical training alone may not be adequately preparing people to return to living in their communities after hip fracture.More emphasis should be placed on strategies to increase confidence during rehabilitation after hip fracture.