International Journal of Clinical Case Reports, 2025, Vol.15, No.4, 148-158 http://medscipublisher.com/index.php/ijccr 152 four times more likely to be able to walk independently than those who were active late (Nakamura et al., 2025). Even when age and mental condition are taken into account (Catalano-Nadakhovskaia et al., 2025), sitting up and moving within 24 hours after surgery means a better recovery of mobility within 30 days. These practices can enhance the activity ability of patients, improve the Barthel index and Harris score, and also help patients recover to the pre-injury state more quickly (Kuru and Olaperar, 2019; Xiang et al., 2021). In addition, arranging activities as early as possible, including bed exercises and gradually increasing the physical burden, can accelerate the improvement of gait, muscle strength and balance ability. Walking analysis revealed that regardless of the surgical method used, the number and duration of walking during hospitalization increased significantly, indicating that early activity has universal benefits for physical recovery (Figure 2) (Aborukbah et al., 2024; Hecht et al., 2025). Figure 2 Averaged (SD) sagittal joint kinematics of the operated (blue) and healthy (green) leg for the hip, knee, and ankle as a function of the gait cycle (0~100%) (Adopted from Hecht et al., 2025) Image caption: The gray shaded areas indicate significant differences in averaged sagittal joint kinematics between the operated and healthy leg (Adopted from Hecht et al., 2025) 5.2 Role in preventing postoperative health problems Starting to be active immediately after surgery can significantly reduce the risk of common postoperative health problems. Patients who were active as early as possible had a lower incidence of confusion, pulmonary infection, urinary tract infection, leg blood clots and pressure sores (Baer et al., 2019; Aprisunadi et al., 2021; Goubar et al., 2021). Studies have found that patients who lie down for a long time are approximately twice as likely to have health problems as those who move early (Kenony-smith et al., 2019; Ma et al., 2025). Early recovery can also shorten the length of hospital stay and reduce the risk of death, which is an important way to improve overall outcomes (Baer et al., 2019; Aprisunadi et al., 2021; Tang et al., 2025). Moreover, early activity is most useful for patients with poor preoperative physical condition, which can reduce health problems and make recovery safer and more effective (Kenony-Smith et al., 2019). These findings suggest that early activity can serve as a key measure for postoperative care in elderly patients with hip fractures (Goubar et al., 2021; Aprisunadi et al., 2021). 5.3 Improvement of psychological state and quality of life Early activities not only help the body recover, but also benefit mental health and quality of life. Patients who participated in early activities said that they had less anxiety, stronger confidence and were more satisfied with the rehabilitation process (Xiang et al., 2021; Aborukbah et al., 2024). Quality of life indicators such as the EQ-5D index were significantly better in the early activity group, although the difference might not be significant (Xiang et al., 2021). In addition, early activity can make people more independent and reduce the fear of falling, which is very common among elderly patients after hip fractures. These psychological benefits can encourage people to persist in rehabilitation, contribute to long-term functional improvement, and ultimately enhance the overall quality of life (Aprisunadi et al., 2021; Aborukbah et al., 2024).
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