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.
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
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
Parallel
Conventional hospital physiotherapy
Other interventionStandard structured physiotherapy program delivered once daily, Monday through Friday, during the hospital stay, following a two-phase protocol (seated exercises; sit-to-stand and gait training).
Automated motivational support and movement-capture system
DeviceRGB camera-based system using a body-pose estimation model (MediaPipe) to record movement during exercise sessions for deferred, off-line biomechanical analysis. Provides only pre-scheduled, generic auditory and visual motivational feedback, independent of how the patient performs the exercise; performs no facial recognition, no automated biometric identification, and no real-time technical correction.
Physical performance - Short Physical Performance Battery (SPPB)
The Short Physical Performance Battery (SPPB) is a standardized, validated measure of lower-extremity physical function in older adults. It combines three timed tests: standing balance (feet together, semi-tandem, and tandem positions), gait speed over a 4-meter walk, and lower-limb strength (five repeated chair stands, performed without using the arms). Each component is scored from 0 to 4, for a total score ranging from 0 (worst) to 12 (best). Lower scores indicate greater functional impairment and a higher risk of disability and falls.
Pain - Visual Analog Scale (VAS)
The Visual Analog Scale (VAS) is a self-reported instrument for measuring subjective pain intensity using a 10-centimeter line, where 0 represents no pain and 10 represents the worst pain imaginable. The participant marks the point on the line that best reflects their pain; the resulting score, measured in centimeters, classifies pain as mild (1-3), moderate (4-7), or severe (8-10).
Muscle strength - Medical Research Council (MRC) Scale
The Medical Research Council (MRC) Scale is a manual muscle-testing method used to assess the strength of the knee flexor/extensor, hip flexor/extensor, and hip abductor muscle groups. Each muscle group is scored from 0 to 5, where 0 indicates no visible or palpable contraction and 5 indicates normal strength against maximal resistance.
Joint range of motion - Goniometry
Active joint range of motion is measured with a goniometer for knee flexion-extension and hip flexion-extension and abduction.
Basic activities of daily living - Barthel Index
The Barthel Index assesses a person's level of independence in ten basic activities of daily living, such as eating, bathing, dressing, and toileting. Scores from each activity are summed for a total ranging from 0 to 100, with higher scores indicating greater independence (100 = total independence; 0-20 = total dependence).
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