International Journal of Clinical Case Reports, 2025, Vol.15, No.4, 148-158 http://medscipublisher.com/index.php/ijccr 154 for patients (Said et al., 2021). Furthermore, clinical guidelines often fail to take into account the total time patients spend in bed before and after surgery, which may affect the occurrence and recovery of health problems. The lack of a complete evidence-based program for the needs of elderly patients with hip fractures has hindered early activity from becoming a routine practice (Gray et al., 2023; Horton et al., 2023). 7.2 Elderly patients have significant individual differences and poor compliance There are significant differences in health status, cognitive ability and psychological state among elderly patients with hip fractures before the onset of the disease, all of which can affect their ability and willingness to participate in early mobilization (Gray et al., 2023). Delirium, mental confusion, low blood pressure and risks of manual operation are all common obstructive factors. Many patients may refuse or be unable to follow the activity suggestions (Kammerlander et al., 2018). For instance, studies have shown that less than half of the patients were active within 48 hours after surgery, and those with delirium or poor pre-illness activity ability were the least likely to be active early (Said et al., 2021). In addition, elderly patients often have difficulty adhering to the activity restrictions after surgery. Studies have shown that even with standard rehabilitation training, most patients are unable to meet the prescribed limits (Kammerlander et al., 2018). The differences among these individuals require highly tailored solutions, which also bring continuous pressure to caregivers and recovery teams. 7.3 The number of evidence-based clinical studies is small and their quality needs to be improved Although everyone understands that early activity is good, there are still few high-quality and powerful studies specifically examining its effect on elderly patients with hip fractures and the best practices (Agarwal et al., 2024). Many studies are observational in nature, involve a small number of people, or have inconsistent definitions and methods of evaluation results, which reduces the credibility and applicability of the research results. The systematic summary emphasizes the need for more experimental and quasi-experimental studies to explore the causal relationship and long-term effects of perioperative intervention on activity and function (Gray et al., 2023; Sarkies et al., 2023). Due to the lack of strong evidence, it is difficult to formulate clear, evidence-based guiding principles and have all relevant parties recognize the value of early activities. Future research should focus on large-scale, well-designed experiments and standardized reports to lay a more reliable evidence base for practical nursing work (Gray et al., 2023; Sarkies et al., 2023; Agarwal et al., 2024). 8 Future research and Nursing Work Directions 8.1 More strictly controlled experiments and high-quality research are needed Although everyone knows that it is better to get active as early as possible, there is still an urgent need for more high-quality, large-sample strictly controlled trials (RCTS) to develop a unified approach and identify which patient groups will benefit the most. Most of the current evidence comes from observational or retrospective studies, which may be interfered with by other factors, and the practices and definitions are often inconsistent (Aprisunadi et al., 2021). Strict controlled experiments are crucial for determining the optimal activity time, frequency and format, as well as evaluating long-term functional and quality of life outcomes (Catalano-Nadakhovskaia et al., 2025; Nakamura et al., 2025). In addition, future research should fill in some gaps, such as the impact of early activity on specific health issues, the effectiveness of spending, and the role of pre-injury health. The research should also examine the difficulties in actual implementation and how to improve cooperation, especially among people with weak bodies or unclear minds (Aprisunadi et al., 2021; Said et al., 2021; Catalano-Nadakhovskaia et al., 2025). 8.2 Development of individualized and intelligent technology-integrated nursing methods Individualized care methods that take into account the individual characteristics of patients (such as age, mental condition, other diseases, pre-injury activity ability, etc.) are very important for enhancing the effect of early activity. Tailoring assistance measures according to patients' needs can enhance cooperation, reduce health
RkJQdWJsaXNoZXIy MjQ4ODYzNA==