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Progressive balance training program for total hip arthroplasty patients using behavior change wheel theory

  • Jianying Liu1
  • Xiaoyan Liu1,*,
  • Ye Li1
  • Huichao Liu1
  • Xing Liu1
  • Qian Li1

1Department of Orthopedics, West China Hospital of Sichuan University, 610000 Chengdu, Sichuan, China

DOI: 10.22514/jomh.2024.011 Vol.20,Issue 1,January 2024 pp.81-89

Submitted: 17 October 2023 Accepted: 20 December 2023

Published: 30 January 2024

*Corresponding Author(s): Xiaoyan Liu E-mail:


Femoral neck fractures are a common type of fracture, accounting for approximately 3.58% of total body fractures and about 50% of proximal femoral fractures. They are particularly prevalent in elderly individuals with osteoporosis, especially those aged 65 and older. This study aims to develop and implement a progressive balance training program for elderly femoral neck fracture patients, guided by the behavior change wheel theory. Through literature review and expert consultation, we developed a progressive balance training program using the behavior change wheel theory. We selected 83 patients admitted to our orthopedics department for hip surgery between January 2022 and December 2022 and divided them into a control group (n = 42) and an intervention group (n = 41). The control group followed a standard exercise program, while the intervention group underwent the progressive balance training program. Their rehabilitation outcomes were compared using the Berg Balance Scale, Harris hip joint function assessment, and the Chinese version of the Fall Efficiency Scale at the first bedside standing, as well as at 2 weeks, 6 weeks and 12 weeks after the operation. Repeated measures analysis of variance revealed statistically significant time-related effects, interaction effects and between-group effects in both groups for the Berg Balance Scale scores (Ftime = 5753.969, Finteraction = 221.20, Fbetween−groups = 1496.285), Harris hip joint function scores (Ftime = 2750.864, Finteraction = 115.315, Fbetween−groups = 760.690), and Fall Efficiency Scale scores (Ftime = 2590.021, Finteraction = 176.961, Fbetween−groups = 625.033) postoperatively. We conclude that the progressive balance training program developed based on the behavior change wheel theory can accelerate the postoperative balance recovery in total hip arthroplasty patients, promote hip joint function recovery, and reduce the fear of falling among patients.


Total hip replacement; Men; Behavioral change theory; Progressive training; Rehabilitation care

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Jianying Liu,Xiaoyan Liu,Ye Li,Huichao Liu,Xing Liu,Qian Li. Progressive balance training program for total hip arthroplasty patients using behavior change wheel theory. Journal of Men's Health. 2024. 20(1);81-89.


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