Osteoporosis International

, Volume 30, Issue 7, pp 1371–1381 | Cite as

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

  • K. Fischer
  • M. Trombik
  • G. Freystätter
  • A. Egli
  • R. Theiler
  • H.A. Bischoff-FerrariEmail author
Original Article



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)



Functional recovery Hip fracture Objective functional tests Subjective physical functioning Timeline 



This project was funded by the Baugarten Foundation Centre Grant for the Centre on Aging and Mobility (Dr. Bischoff-Ferrari). The original trial was supported by Swiss National Foundations (NFP-53) (Drs Bischoff-Ferrari and Theiler); Vontobel Foundation (Dr Bischoff-Ferrari; and Swiss National Foundations professorship grant PP00B-114864 (Dr Bischoff-Ferrari).

Compliance with ethical standards

Conflicts of interest


Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

198_2019_4944_MOESM1_ESM.pdf (5.7 mb)
ESM 1 (PDF 5819 kb)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  • K. Fischer
    • 1
    • 2
  • M. Trombik
    • 1
    • 2
  • G. Freystätter
    • 1
    • 2
    • 3
  • A. Egli
    • 1
    • 2
  • R. Theiler
    • 1
    • 2
    • 3
  • H.A. Bischoff-Ferrari
    • 1
    • 2
    • 3
    • 4
    Email author
  1. 1.Department of Geriatrics and Aging Research, Geriatric ClinicUniversity Hospital Zurich and University of ZurichZurichSwitzerland
  2. 2.Centre on Aging and MobilityUniversity Hospital Zurich and City Hospital WaidZurichSwitzerland
  3. 3.Centre for Senior Trauma CareUniversity Hospital ZurichZurichSwitzerland
  4. 4.City Hospital WaidUniversity Clinic for Acute Geriatric CareZurichSwitzerland

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