Psychological resilience tied to better walking speed, distance in older adults after hip fracture

Older adults with better psychological resilience show better walking-related outcomes after hip fracture, reports a recent study.

Drawing from the Community Ambulation Project, researchers assessed 210 community-dwelling older adults (aged ≥60 years, 76.7 percent women) who had experienced minor-trauma hip fractures. All participants had undergone home-based, therapist-guided intervention programmes. The 6-item Brief Resilience Scale (BRS) was used to assess psychological resilience.

At baseline, the mean BRS score was 3.3, while average 4-meter gait speed was 0.60 m/s, and average 50-foot walk gait speed was 0.67 m/s. Participants also had a mean baseline 6-minute walk distance of 186.9 m.

Analysis of covariance, adjusted for confounders, showed that compared with the lowest BRS group (score <3.0), those in the highest quartile (score >3.5) showed a significant improvement in the 50-foot walk test after 16 weeks of intervention (estimate, 0.107; p=0.008). Similar changes were reported for 4-meter gait speed (estimate, 0.063; p=0.061) and 6-minute walk distance (estimate, 25.488; p=0.056), though these were only of borderline significance.

Notably, patients who scored 3.0–3.33 points on the BRS, the second-lowest category, showed significant improvements in 4-meter gait speed (estimate, 0.091; p=0.008) and 50-foot walk gait speed (estimate, 0.092; p=0.026) relative to those with the lowest psychological resilience.

“Findings suggest that psychological resilience should be assessed before starting post hip-fracture rehabilitation, and that interventions to address community-dwelling older adults' psychological resilience should be developed and tested with the aim of improving walking measures following hip fracture, leading to greater capacity for independent living,” the researchers said.