A large new study suggests that providing rehabilitation therapy on weekends and public holidays after hip fracture surgery can significantly improve recovery for some older patients—especially those who are most frail.
The research, involving nearly 78,000 patients, highlights how early and consistent rehabilitation can help elderly individuals regain independence in daily life.
Hip fractures are common among older adults and often lead to a decline in the ability to perform everyday tasks such as bathing, dressing, and walking.
Even after successful surgery, many patients struggle to return to their previous level of independence.
Rehabilitation therapy plays a crucial role in helping them rebuild strength, mobility, and confidence.
Previous research has suggested that therapy delivered outside normal weekday hours, including weekends and holidays, can speed recovery.
However, many hospitals face staff shortages that make it difficult to provide rehabilitation services every day.
As a result, doctors and therapists often must decide which patients should receive priority treatment during these times.
To better understand who benefits most, researchers from a Graduate School of Medicine in Japan analyzed data from 77,947 patients aged 60 and older who underwent surgery for hip fractures.
The study, published in the journal Annals of Physical and Rehabilitation Medicine, examined whether receiving rehabilitation within the first week after surgery—including on holidays—affected recovery by the time patients were discharged.
The team used a standard measurement called the Barthel Index to assess patients’ ability to perform activities of daily living. Scores range from 0, meaning complete dependence on others, to 100, meaning full independence. Researchers compared patients’ scores at admission with their scores at discharge.
The results showed that patients over the age of 80 and those who were most dependent at the start benefited the most from rehabilitation provided on holidays. These individuals had higher independence scores by the time they left the hospital compared with similar patients who did not receive holiday therapy.
In contrast, patients who already had relatively good function when admitted did not show significant additional improvement from extra holiday sessions. This suggests that limited rehabilitation resources could be used most effectively by focusing on the oldest and most vulnerable patients.
Lead researcher Tsubasa Bito said the findings provide strong evidence to support prioritizing therapy for patients who are most at risk of losing independence. Until now, many decisions about holiday rehabilitation have relied mainly on clinical judgment rather than large-scale data.
Professor Ayumi Shintani added that the study offers practical guidance for hospitals facing staffing challenges. By targeting patients who stand to gain the most, healthcare providers may be able to improve outcomes without increasing overall workload.
As populations age worldwide, hip fractures are expected to become even more common. The study highlights the importance of timely rehabilitation in helping older adults maintain independence and quality of life after a serious injury.
