Prescribing physical activity for patients with hip fracture during rehabilitation

This is a phase I dose-response trial to find out how much physical activity, in the form of walking, can be prescribed for people with hip fracture during rehabilitation in terms of safety and feasibility. In addition to receiving usual rehabilitation care, groups of 3 participants will be individually supervised to walk at a prescribed level of physical activity for 5 consecutive days. This prescribed level of physical activity will not change for individual participants over the 5 days but may escalate for subsequent groups of participants. The dose level of prescribed physical activity will follow a modified Fibonacci scheme starting with an initial dose of 3 minutes of moderate intensity supervised walking per day for the first group of participants. Moderate intensity walking will be defined as a 3 on the modified Borg 0-10 perceived exertion scale, where 3 = “I am still comfortable but am breathing a little harder.” Dose escalation will depend on the presence or absence of adverse incidents among the group of 3 participants. Depending on the feasibility and safety of the prescribed dose of walking, the dose may or may not be escalated between subsequent groups of participants. Dose escalation will start with early larger dose increments between groups which get smaller for higher doses until the guideline stopping value of 30 minutes of walking per day is reached (i.e. 3, 6, 10, 15, 21, 27, 30 mins). The trial will stop when/if a group of participants can achieve 30 minutes of prescribed walking as this reflects physical activity guidelines.