AI-Supported Physiotherapy After Hip Fracture in Frail Older Adults

Purpose Hip fractures in older adults often cause a serious loss of strength and independence. Physical therapy helps people recover, but patients do not always exercise consistently or correctly. This study tests whether adding an automated motivational support tool to physical therapy helps patients recover better than physical therapy alone. How the tool works The tool uses a regular camera to record movement during exercise. It does not use facial recognition. It gives the patient simple, encouraging messages, such as "great job" or "keep going." It does not give medical advice or correct the patient's movements during the session. The research team reviews the recordings later; they are not reviewed in real time. Who can join People age 70 or older who had surgery for a hip fracture and are staying in the Orthogeriatrics Unit at Ramón y Cajal University Hospital, in Madrid, Spain. What happens in the study Forty-eight people will take part. Half will receive standard physical therapy plus one daily session with the motivational tool. Half will receive standard physical therapy alone. Researchers will measure physical performance with a short walking and balance test. They will measure it three times: at the start, when the patient leaves the hospital, and one month later. Why it matters This study will show whether an automated motivational tool helps patients recover more strength and function after a hip fracture.

Inclusion Criteria: * Age ≥ 70 years * Diagnosis of hip fracture due to bone fragility * Hospital admission to the Orthogeriatrics Unit, Ramón y Cajal University Hospital (Ward 3DA, rooms 301-314) * Signed informed consent * Frailty, assessed with the FRAIL-Spain scale (score 3 to 5) * Weight-bearing authorized by the medical team (Trauma Surgery Department) Exclusion Criteria: * Hip fracture due to high-energy trauma * Pathological fracture (bone metastasis or tumor) * Pre-fracture ambulation capacity (FAC) of 0 to 2 * Other coexisting fractures * Inability to complete clinical follow-up * Lack of cooperation with the physiotherapy program * Neurodegenerative disease at a moderate stage or beyond (cognitive impairment GDS ≥ 6, or Parkinson's disease Hoehn-Yahr stage 3-5) * Institutionalized patients (due to earlier hospital discharge) * Post-surgical complications (e.g., infection, poor surgical wound healing, suspected deep vein thrombosis) * History of underlying conditions affecting balance or posture (cancer, dizziness, vertigo, or stroke) * Physical disability that could compromise sample homogeneity * Sensory impairment preventing use of digital tools * Severe cognitive impairment (Lobo's Mini-Mental State Examination score ≤ 9, equivalent to GDS ≥ 6)