International Journal of Clinical Case Reports, 2025, Vol.15, No.4, 148-158 http://medscipublisher.com/index.php/ijccr 150 Health problems not only affect physical recovery but also cause serious psychological and social difficulties. Persistent pain and confusion can make it difficult for patients to move around, prevent them from living independently, and also reduce their related quality of healthy life. In addition, the possibility of rehospitalization and long-term hospitalization increases, further affecting the overall recovery and living conditions of elderly patients (Pepeters et al., 2016; Alexiou et al., 2018; Yu and Zheng, 2022; Sun et al., 2023). 2.3 Main factors affecting postoperative recovery The postoperative recovery of elderly patients with hip fractures is influenced by the interaction of physiological, psychological and social factors. Key factors include age, physical condition before fracture, cognitive ability, other diseases, nutritional status and the presence or absence of complications (Kim et al., 2012; Yu and Zheng, 2022). For instance, patients who are elderly, have cognitive problems, or suffer from poor nutrition often have poor recovery and a high risk of death (Peters et al., 2016; Alexiou et al., 2018; Araiza-Nava et al., 2022). The quality of social support and care during the rehabilitation period is also very important for rehabilitation. The psychological state of family caregivers directly affects the physical and mental recovery of patients. When the nursing staff are in good condition, patients will recover better (Liu et al., 2015). In addition, new biomarkers such as lymphocyte calcium-specific index (LRCa3) are emerging as useful tools for predicting long-term functional recovery, enabling more personalized patient management (Wu et al., 2025). 3 The Theoretical Basis and Mechanism of Early Mobilization 3.1 Definition and implementation standards of early mobilization Early activity generally refers to the fact that patients should start to engage in activities such as sitting, standing or walking within 24~48 hours after hip fracture surgery. The implementation standards emphasize the need for the collaboration of multiple disciplines, including nurses, physical therapists, and doctors, to ensure safety and restore physical functions to the best possible state. The treatment plan is usually to gradually increase the activity level, starting with someone helping to sit down, and then perform more intense activities within the range that the patient can tolerate (Sallehuddin and Ong, 2020; Said et al., 2021; Mashimo et al., 2022; Catalano-Nadakhovskaia et al., 2025). It is very important to adhere to these standards because research shows that allowing patients to move within 48 hours after surgery can improve their walking ability, increase their discharge rate, and enable them to complete daily life more independently. Late initiation of physical therapy, unstable physical condition, and complications before and after surgery are all common problems that affect timely activities. This also indicates that it is necessary to coordinate care and formulate clear plans (Said et al., 2021; Mashimo et al., 2022). 3.2 Physical principles for promoting blood flow and restoring muscle function Early activity can accelerate blood flow, reduce the risk of blood vessel blockage, and provide more oxygen to body tissues. Exercise can activate the muscle pump function in the legs, which helps prevent blood clots from forming in the legs and keeps the heart and vascular system stable. This physical response is particularly important for elderly patients because they have a higher risk of circulatory system problems when they stay in bed for a long time (Baer et al., 2019; Aprisunadi et al., 2021; Aborukbah et al., 2024). In addition, early activity helps maintain muscle mass and function, and prevents rapid muscle loss and joint stiffness caused by inactivity. Weight-bearing and strength training shortly after surgery can accelerate the recovery of mobility, improve balance, and help return to the walking state before injury, which is very crucial for regaining the ability to take care of oneself (Aprisunadi et al., 2021; Aborukbah et al., 2024). 3.3 The effect of improving psychological state and reducing complications Early activities are of great benefit to the mind, as they can reduce anxiety, improve mood and enhance confidence in recovery. Patients who engage in early activities are usually more satisfied with the rehabilitation process and have a more positive perspective, which can further motivate them to participate in the treatment and adhere to the rehabilitation plan (Aprisunadi et al., 2021; Aborukbah et al., 2024; Choudhury, 2024).
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