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Stratify-Hip rehabilitation trial

Overview

In the UK, around 70,000 people aged over 60 fall and break their hip each year. The best way to support recovery after surgery is not yet clear, so a new rehabilitation approach called STRATIFY was developed. STRATIFY groups people with similar needs after a hip fracture and provides extra hospital-based rehabilitation tailored to each group. 

Low needs: Exercises and support to speak up about their needs. 

Medium needs: Education, a goal-based walking programme, and help planning an earlier discharge. 

High needs: Education, a goal-based programme focused on everyday tasks (e.g., dressing), extra checks for pain and mood, care planning, and guidance on bringing familiar items from home to reduce confusion. 

This study wanted to see if it is possible for the NHS to deliver STRATIFY for older adults who break their hip.

What we found

We invited older people with a broken hip to take part. All had usual hospital care. Half of these people, selected at random, also had STRATIFY provided to them by a physiotherapist/occupational therapist. We collected information on who could take part. For those who took part, information was collected at the study beginning, end, and 12 weeks later. 

This study showed it is possible for the NHS to deliver STRATIFY for older adults who break their hip. The extra care was acceptable to people who took part and therapists. A larger study is now needed to see if this extra care works to help older adults recover better.

Why it matters

This is the first time routinely collected data has been used to identify people with different rehabilitation need to inform rehabilitation care provision. The research showed that the NHS could deliver STRATIFY to provide more tailored care to help people recover from hip fracture in hospital.  The findings are ready to be tested further in future research to see whether STRATIFY does help people recover better.  

This research supported a patient and public involvement (PPI) group called TROOP, giving older adults after hip fracture and their carers a voice in this and future research. It supported members to feel recognised, have a say in what matters to them, and help ensure other older adults are informed about new developments in rehabilitation.

Outputs and reach

Publications:  

Presentations 

  • The protocol was presented at the Global Fragility Fracture Network, Oslo (2023).  
  • Patient and professional perspectives on the STRATIFY intervention after hip fracture (Fragility Fracture Network, Porto 2025) 
  • STRATIFY: The results of a stratified approach to rehabilitation after hip fracture. British Geriatric Society meeting Belfast. Invited Keynote, 2025.

Who was involved

We worked with patients to plan and deliver the study. They helped us develop materials on the study findings which were shared with patients and the public.    

Lead: Katie J Sheehan, Bone & Joint Health, QMUL 
Co-lead: Julie Whitney, Kings College London 

Collaborators:  

Rhian Milton-Cole, Bone & Joint Health, QMUL 
Rebecca Edwards, Guys and St Thomas’s NHS Foundation Trust 
Stefanny Guerra, Bone & Joint Health, QMUL 
Salma Ayis, Kings College London  
Aicha Goubar, Kings College London 
Nadine E. Foster, University of Queensland 
Finbarr C. Martin, Kings College London 
Emma Godfrey, Kings College London 
Ian D. Cameron, University of Sydney 
Celia L. Gregson, University of Bristol 
Nicola E. Walsh, University of the West of England, Bristol 
Anna Ferguson Montague, PPI representative TROOP 
Charlie Surman, Bone & Joint Health, QMUL 
Jodie Adams, Bone & Joint Health, QMUL 
Catherine Sackley, University of Nottingham 

Funded by: This was funded by a UK Research & Innovation Future Leaders Fellowship awarded to Professor Katie Sheehan. 

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