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Factors that influence exercise activity among women post hip fracture participating in the Exercise Plus Program

Authors Barbara Resnick, Denise Orwig, Christopher D′Adamo, Janet Yu-Yahiro, William Hawkes, et al

Published 15 October 2007 Volume 2007:2(3) Pages 413—427

Barbara Resnick1, Denise Orwig2, Christopher D’Adamo2, Janet Yu-Yahiro3, William Hawkes2, Michelle Shardell2, Justine Golden2, Sheryl Zimmerman4, Jay Magaziner2

1University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD,21201, USA; 2University of Maryland School of Medicine, Howard Hall, Redwood Street, Baltimore MD 21201, USA; 3Department of Orthopaedic Surgery, Union Memorial Hospital, Baltimore, USA; 4University of North Carolina Chapel Hill, 301 Pittsboro St., CB#3550, Chapel Hill, NC 27599-3550, USA

Abstract: Using a social ecological model, this paper describes selected intra- and interpersonal factors that influence exercise behavior in women post hip fracture who participated in the Exercise Plus Program. Model testing of factors that influence exercise behavior at 2, 6 and 12 months post hip fracture was done. The full model hypothesized that demographic variables; cognitive, affective, physical and functional status; pain; fear of falling; social support for exercise, and exposure to the Exercise Plus Program would influence self-efficacy, outcome expectations, and stage of change both directly and indirectly influencing total time spent exercising. Two hundred and nine female hip fracture patients (age 81.0 ± 6.9), the majority of whom were Caucasian (97%), participated in this study. The three predictive models tested across the 12 month recovery trajectory suggest that somewhat different factors may influence exercise over the recovery period and the models explained 8 to 21% of the variance in time spent exercising. To optimize exercise activity post hip fracture, older adults should be helped to realistically assess their self-efficacy and outcome expectations related to exercise, health care providers and friends/peers should be encouraged to reinforce the positive benefits of exercise post hip fracture, and fear of falling should be addressed throughout the entire hip fracture recovery trajectory.

Keywords: hip fracture, exercise, self-efficacy, outcome expectations, recovery

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