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INITIATE: Increased mobility in hospital after hip fracture

A broken hip is a serious injury that affects around 70,000 older adults in the UK every year. After surgery, many people struggle to regain their mobility, and one in six never return home. Current hospital targets encourage getting patients out of bed within 48 hours and offering regular physiotherapy. However, moving even more might help people heal better. The INITIATE clinical trial tests whether increased physical activity on the hospital ward helps patients get back on their feet sooner. Researchers want to know if extra daily movement reduces time spent in hospital and helps people continue living in their own homes. The study is open to adults aged 60 and over recovering from hip fracture surgery. Taking part involves sharing health updates while in hospital, and answering brief questions at one month and four months after surgery.

At a glance

Status
Recruiting
Sponsor
University of Oxford
Enrolment target
2,310
Start
01 Aug 2024
Estimated completion
31 Oct 2026

What is this study about?

Breaking a hip is a life-changing event for many older people. In the UK, about 70,000 people fracture a hip each year. The injury often leads to a major loss of independence, and long periods in bed can lead to other serious health complications. Finding safe, effective ways to help people get back on their feet quickly is vital.

NHS hospitals currently aim to help patients out of bed within two days of surgery and provide weekly physiotherapy sessions. Evidence suggests that patients who manage to move around even more than this recover more quickly. Patients, carers, and healthcare teams have asked whether simply doing more regular, supported movement on the ward could make a real difference.

The INITIATE study is designed to answer this question. Researchers are comparing standard ward care with care that includes extra daily movement and mobility support. They want to see whether this helps patients return home sooner, lowers the chance of complications, and helps people stay independent in their own homes for longer.

The trial is being run by specialist doctors and researchers from the University of Oxford and the University of Bristol. It is funded by the National Institute for Health and Care Research (NIHR), the research partner of the NHS, to help improve care across the country.

Key takeaways

  • Tests whether extra movement on hospital wards helps hip fracture patients recover faster.
  • Open to adults aged 60 and over who have had hip surgery in the past 48 hours.
  • Does not require any new medicines or extra hospital visits after you go home.
  • Follow-up checks happen by phone or post at 1 month and 4 months after surgery.
  • Participation is voluntary and will not affect the quality of your regular NHS care.

Who may be eligible?

The INITIATE study is open to adults aged 60 and older who have broken a hip and are being treated at a participating NHS hospital. People can join if they are due to have surgery or if they had their hip operation within the last 48 hours. Patients with memory difficulties, such as dementia, can also take part with the support of their families.

The study is not suitable for everyone. People cannot join if their broken hip was caused by abnormal bone, such as a bone tumour, or if their medical team feels it is unsafe for them to move after surgery.

Additionally, people who were already unable to walk before their injury (for example, those completely confined to a bed or chair) cannot participate. Patients already taking part in another clinical trial for a broken hip are also excluded.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

  1. I am aged 60 or older.
  2. I have broken a hip and had surgery within the last 48 hours (or am waiting for surgery).
  3. Before breaking my hip, I was able to walk (I was not confined to a bed or chair).
  4. My broken hip was not caused by a bone tumour or cancer.
  5. My doctor agrees it is safe for me to start moving after my operation.
Answer every question to see your result.

What does participation involve?

If you take part in INITIATE, your hospital care will focus on recovery and safe movement. The study does not involve any experimental drugs or extra medical procedures. While you are in hospital, the research team will collect standard information about your health, surgery, and how well you can move.

After you leave hospital, researchers will contact you (or your carer) twice: roughly 30 days after your operation, and again around 120 days after your operation. These check-ins are usually done over the phone or by post and involve answering simple questions about your mobility, daily activities, and general health. In total, your participation in the study lasts about four months from the date of your surgery.

Potential risks and benefits

Taking part may not give you any direct personal benefit, but the findings could greatly improve hospital care for thousands of older people who break a hip in the future. As with any physical activity following surgery, moving around can cause mild muscle soreness or tiredness, and there is a small risk of falls. However, all activity is supervised by trained ward staff to keep you safe. Joining the study is completely voluntary, and you can withdraw at any time without giving a reason and without your standard NHS care being affected.

Locations (22)

  • John Radcliffe Hospital
    Approximate
    Oxford, England
  • Southmead Hospital
    Approximate
    Bristol, England
  • Stepping Hill Hospital
    Approximate
    Stockport, England
  • Leicester Royal Infirmary
    Approximate
    Leicester, England
  • Royal Berkshire Hospital
    Approximate
    Reading, England
  • University Hospital Coventry & Warwickshire
    Unverified
    Coventry, England
  • Musgrove Park Hospital (taunton)
    Unverified
    Taunton, England
  • Hull Royal Infirmary
    Unverified
    Hull, England
  • St George's Hospital
    Unverified
    London, England
  • Airedale General Hospital
    Unverified
    Keighley, England
  • The Royal Victoria Infirmary
    Unverified
    Newcastle upon Tyne, England
  • Cumberland Infirmary
    Unverified
    Carlisle, England

Common questions

Will I need to take any new or experimental medicines?

No. This study only looks at physical movement and rehabilitation support on the ward. It does not test any new drugs.

Can people with dementia or memory problems take part?

Yes. The study includes patients with and without the capacity to consent. Family members or legal representatives can help make decisions about taking part.

Do I need to come back to the hospital for study appointments?

No extra hospital visits are required. Follow-up checks at 30 days and 120 days can be completed over the phone, by post, or online from home.

What happens if I feel too tired or sore to move?

Your comfort and safety always come first. Ward staff will support you to move within your personal limits and will never force you to do anything unsafe or overly painful.

Does taking part cost anything?

No. The study is fully funded by the NHS National Institute for Health and Care Research, and participation is entirely free.

How to find out more

Gratian Vandici

Always speak to your GP or specialist before deciding to take part in a study.

Interested in taking part?

Register your interest

Share your details and the research team for "INITIATE: Increased mobility in hospital after hip fracture…" will contact you if you may be eligible. Always speak to your GP before agreeing to take part.

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