Background: Step count has emerged as an objective indicator of physical activity, yet its association with functional recovery following hip fracture remains unclear. Objective: This study aimed to evaluate daily step counts after hospital discharge in older adults with hip fracture and to determine thresholds associated with functional improvement. Methods: A prospective, observational study was conducted in patients aged over 75 years admitted with hip fracture. Daily steps were recorded using validated activity trackers. Functional status was assessed at one, three, and six months after discharge through telephone interviews. Functional improvement was defined as an increase of at least 5 points on the Barthel Index. Step count thresholds were estimated using Liu's method based on receiver operating characteristic (ROC) analysis. Results: Ninety-four patients were included with a mean age of 83.2 ± 6 years, with 80.8% being female. Of the patients included in the study who recorded their daily steps after hip surgery, 59 patients (72%) improved during the first month after discharge with a median of 220 daily steps (IQR: 103.5-494.5; cut-off point at 150 steps). At the third month after hip fracture, 77 patients (86.5%) showed functional improvement with a median of 778 steps (IQR: 263-1697; cut-off point at 425 steps). At month six, 65 patients (80.2%) showed functional improvement with a median of 1757 steps (IQR: 696-3388; cut-off point at 2404 steps). Conclusions: In older adults discharged after hip fracture, achieving more than 150 steps per day in the first month, 425 steps in the third month, and 2404 steps by the sixth month was associated with functional improvement on the Barthel Index. These findings suggest potential activity targets to support mobility recovery. However, further research is warranted to confirm these associations in larger and more diverse populations. These thresholds, although exploratory, may also assist clinicians in monitoring and identifying patients at risk of poor functional recovery.

Keywords: daily steps; functional recovery; hip fracture; older adults; physical activity.

背景：步数已成为身体活动的客观指标，但其与髋部骨折后功能恢复的关系尚不清楚。目的：本研究旨在评估髋部骨折老年人出院后的每日步数，并确定与功能改善相关的阈值。方法：在75岁以上的因髋部骨折入院患者中进行了一项前瞻性观察性研究。使用经过验证的活动追踪器记录每天的步数。通过电话访谈分别于出院后1个月、3个月和6个月评估患者的体能状态。功能改善定义为Barthel指数至少增加5分。使用基于接收者操作特征（ROC）分析的Liu方法估算步数阈值。结果：纳入了94名患者，平均年龄83.2±6岁，其中80.8%是女性。在记录每日步数的研究参与者中，在出院后第一个月内有59名（72%）的患者有所改善，其每天步数中位数为220步（四分位间距：103.5-494.5；阈值点在150步）。在髋部骨折后的第三个月，86.5%的患者显示功能改善，每日步数中位数为778步（四分位间距：263-1697；阈值点在425步）。到第六个月时，有80.2%的患者显示功能改善，每天步数中位数为1757步（四分位间距：696-3388；阈值点在2404步）。结论：对于髋部骨折后出院的老年患者，在第一个月内达到每日超过150步、第三个月时达到每天425步以及到第六个月时达到2404步，与Barthel指数的功能改善有关。这些发现表明可能存在支持行走康复的活动目标。然而，需要进一步的研究来确认这些关联在更大和更多样化的人群中的有效性。虽然这些阈值具有探索性，但它们也可能有助于临床医生监测并识别功能恢复不良风险较高的患者。

关键词： 每日步数；功能恢复；髋部骨折；老年人；身体活动。