Prescribing physical activity for people living in the community following hip fracture

This is a Phase I dose-response trial designed to find out how much physical activity, in the form of walking, can be prescribed for people living in the community post hip fracture in terms of safety, tolerability and feasibility. Participants will be individually supervised during their walking by an allied health clinician and can walk with their usual assistive device. Participants will walk for a prescribed period of time (dose level) at a location that is convenient to them. Participants will be instructed to walk at a moderate level of intensity which will be determined by the BORG CR-10 rating of perceived exertion scale, where 3 = moderate “I am still comfortable but am breathing a little harder”. Walking can occur indoors or outdoors and the dose can be spread out over a period of 1 week depending on the participants' needs but participants will be encouraged to complete their physical activity in bouts of 10 minutes or more. For example, dose 3 (35 minutes per week) could be reached in 3 ways: 1) 2 bouts of 10 minutes and one bout of 15 minutes per week; 2) one bout of 25 minutes and one bout of 10 minutes per week; or 3) one bout of 35 minutes per week. The dose level will follow a modified Fibonacci scheme starting with an initial dose of 10 minutes of supervised walking per week for the first 3 participants, with early larger dose increments which get smaller for higher doses until the guideline stopping value of 150 minutes of walking per week is reached (e.g. 10, 20, 35 etc. minutes). Dose escalation will depend on the presence or absence of adverse events or tolerability issues. One hundred and fifty minutes is the maximum minutes of prescribed walking per week because if this is achieved without incident it means that participants can safely meet physical activity guidelines for older adults. Each participant will be involved in the study for a period of 7 days only.