Physical Activity and Hip Fracture Disability: A Review

Objective. The present paper examines pertinent literature sources published in the peer-reviewed English language between 1980 and November 1, 2010 concerning hip fractures. The aim was to highlight potential intervention points to offset the risk of incurring a hip fracture and its attendant disability. Methods. An in-depth search of the literature using the key terms: disability, epidemiology, hip fracture, prevention, and risk factors was conducted, along with data from the author's research base detailing the disability associated with selected hip fracture cases. All articles that dealt with these key topics were reviewed, and relevant data were tabulated and analyzed. Results. Hip fractures remain an important but potentially preventable public health problem. Among the many related remediable risk factors, low physical activity levels are especially important. Related determinants of suboptimal neuromuscular function also contribute significantly to hip fracture disability. Conclusion. Physical activity participation can help to reduce the prevalence and excess disability of hip fractures and should be encouraged. 1. Background to the Problem In spite of much research, hip fractures continue to pose a serious health care problem as far as health policy makers and public health care organizations are concerned. Indeed, despite some evidence of declining hip fracture prevalence rates (e.g., [1, 2]), hip fractures remain a persistent cause of excessive morbidity, reduced life quality, and premature mortality among older adults [3, 4]. In addition, because the observed reversal of the hip fracture secular trend may not apply universally [5], it is likely the annual incidence of hip fractures will increase, rather than decrease over the next few decades [6]. Moreover, since hip fracture prevalence increases exponentially with age [7], as populations age and longevity increases worldwide [8], these injuries are likely to occur at accelerated rates [9]. This is important, because among those who sustain a hip fracture injury and survive, an increasing number continue to experience various degrees of subsequent disability, including the onset of painful disabling hip joint osteoarthritis, a high risk for falls, and further hip fracture injury. As a result, escalating and excessive monetary costs of care for this debilitating injury [8], which includes disability costs, nursing care, rehabilitation care, and surgical costs are predicted as well. The aforementioned likelihood of an increase, rather than a universal decrease in hip fracture prevalence