Supervised Exercise Enhances Recovery Outcomes in Older Women After Hip Fractures, Study Finds

A comprehensive multi-center clinical trial has revealed that supervised exercise programs significantly improve recovery outcomes in older women following hip fractures. The study, known as the STEP-HI (Starting a Testosterone and Exercise Program after Hip Injury), investigated whether adding low-dose testosterone therapy to a structured exercise regimen would enhance mobility and functional recovery compared to exercise alone.

Published in JAMA Network Open, the trial is the largest of its kind involving women aged 65 and older who recently underwent surgical repair for hip fractures. Participants were recruited from eight U.S. clinical sites between 2018 and 2023. The findings indicate that while testosterone gel did not notably improve long-distance mobility, measured by the Six Minute Walk Test, it did have positive effects on short-distance mobility, balance, and the ability to walk without aids at the study's conclusion.

The trial emphasizes the critical role of exercise in rehabilitation, demonstrating that progressive resistance training can lead to remarkable improvements. Some participants, who initially hesitated, advanced to leg presses exceeding 100 pounds, highlighting that it's never too late to begin strength training.

Hip fractures pose a significant health threat to older women, often resulting in persistent functional impairment, pain, and increased risk of subsequent fractures or death. Despite surgical advancements, many women struggle to regain their prior levels of activity and independence post-injury.

The research underscores that although testosterone supplementation did not deliver expected benefits in endurance, it contributed positively to other areas like balance and mobility in some cases. Notably, women who required walking aids at baseline and received combined exercise and testosterone therapy showed greater likelihood of walking unaided after six months, though further studies are needed to confirm this.

Expert insights from principal investigator Jenna M. Bartley, Ph.D., and Dr. George Kuchel highlight the significance of consistent, targeted exercise protocols. They emphasize that structured resistance training is highly tolerable and effective for older women, even during recovery from injury.

Overall, the results affirm that personalized, vigorous exercise remains essential for improving functional outcomes after hip fractures, with potential for further research into complementary therapies like testosterone. The study’s conclusions reinforce the importance of physical activity for maintaining mobility and independence in the aging population.