Living with Fracture: A mixed-method study to understand the impact of upper limb fragility fracture on older women and their lifestyle decisions in relation to physical activity and exercise.

This study will focus on upper limb fragility fracture (ULFF) including: wrist, forearm and humerus. There is little UK research specifically looking in-depth at the impact of osteoporosis-related fracture on physical activity (PA) and previous evidence has focused on hip and spinal fractures. An estimated 23% of fractures (1, 2) involve the wrist and can be a precursor to hip fractures or a warning of an increased risk of falling and fracturing. Yet we do not know the impact of ULFF on PA. Wrist and forearm fracture can lead to pain and deformity and physical restriction compounding a potential decrease in PA (3), with older women already less likely than men to take up and maintain exercise post menopause (4). However, there is strong evidence demonstrating the benefits of PA to physical and mental health generally (5), and for strengthening and preventing osteoporotic bone health specifically (6). We also know that PA is important to older women (7)
Collaborators: Dr Charlotte Salter (NMS), Professor Lee Shepstone (NMS) and Dr Toby Smith (HSC)
Objectives of PhD:
The aim of this study is to inform policy and practice through increased understanding and knowledge of the lived experience of ULFF and the impact these fractures have on physical activity and exercise. This study will involve a systematic review of the literature on ULFF and physical activity, descriptive epidemiology using the SCOOP database and in-depth qualitative interviews with older women. The research objectives are:
1. To undertake a systematic literature review of osteoporosis, fragility fractures and physical activity;
2. To describe the prevalence and incidence of ULFF in the SCOOP dataset comprising 12,000 older women in England;
3. To explore the lived experience and personal meaning of ULFF, including key enablers and barriers in transitions back to a personally acceptable and clinically appropriate level of activity; and,
4. To explore findings with health professionals in order to advance policy and practice