Strengthening recovery: the impact of paired exercises in geriatric hip fracture rehabilitation-the PaLMe project.

Purpose: This study aimed to evaluate the effectiveness of the PaLMe concept, which incorporates paired exercises into rehabilitation for old patients recovering from hip fracture surgery, and to assess the feasibility of implementing an online rehabilitation program in this population.

Methods: A prospective, randomized interventional study was conducted in a hospital setting. A total of 93 participants (mean age: 80.5 years, 66% women) were enrolled and randomized into an intervention group (PaLMe, paired exercises, n = 44) or a control group (individual exercises, n = 49). The study intervention lasted for the duration of the hospital stay, with an average length of 5.6 days. In the PaLMe group, participants were paired using a custom algorithm developed to match patients based on similar clinical and demographic characteristics, fostering interaction and mutual motivation during synchronized exercises. Walking ability was measured by distance walked and level of assistance required, while self-efficacy and motivation were assessed using validated scales. Feasibility was evaluated through recruitment and retention rates, adherence to prescribed sessions, and participant feedback on usability and satisfaction. Data were analyzed using independent t-tests and qualitative feedback.

Results: The PaLMe group demonstrated significantly greater improvements in walking distance, with 66% achieving ≥ 21 m at discharge compared to 43% in the control group (p < .05). Self-efficacy and motivation also improved more in the PaLMe group. Feasibility metrics indicated high program acceptability, with recruitment and retention rates of 37% and 89%, respectively. Adherence to the program was moderate, with 47% of PaLMe participants completing more than 50% of prescribed sessions. Participant feedback highlighted increased confidence, motivation, and satisfaction with the paired exercise format, despite logistical challenges such as scheduling conflicts.

Conclusion: The PaLMe program significantly enhances physical and psychological recovery in senior patients after hip fracture surgery, demonstrating its potential as an effective rehabilitation strategy. Feasibility findings indicate strong acceptability but highlight logistical barriers, such as scheduling conflicts and adherence challenges, which must be addressed to optimize implementation. Further research is warranted to explore long-term outcomes and scalability across broader settings.