Mindfulness-enhanced Prehabilitation for Early Mobilisation: A Computational Framework for Optimising Hip Fracture Recovery through Neurobehavioural and Goal-theoretic Modelling

Abstract Background: Recovery after hip fracture surgery depends heavily on early mobilisation. However, psychological factors such as fear of pain and low motivation often delay ambulation. Current prehabilitation programmes focus on physical preparation and neglect the psychological readiness of patients. This study will aim to evaluate the effectiveness of mindfulness-enhanced prehabilitation for early mobilisation (M-PEM), a framework that combines mindfulness-based pain control and personalised goal setting to enhance post-operative recovery. Methodology: A randomised controlled trial was conducted on 120 patients with hip fractures. Participants were divided into two groups: one received standard prehabilitation, and the other received M-PEM, which included 3 weeks of pre-operative mindfulness training using biofeedback sensors and dynamic goal planning using artificial intelligence. Data were collected preoperatively and up to 2 weeks postoperatively, including pain levels, opioid use, walking ability and gait performance. Data were analysed using independent t-tests and Chi-square tests, with statistical significance set at P < 0.05. Results: Compared to controls, the M-PEM group showed greater reductions in pain (3.2 ± 0.8 vs. 1.9 ± 0.6, P < 0.001), lower opioid consumption (24.5 ± 6.7 morphine milligram equivalents [MME] vs. 38.2 ± 9.1 MME, P < 0.01), earlier ambulation (28.4 ± 6.2 h vs. 45.7 ± 8.9 h, P < 0.001), faster gait speed (0.68 ± 0.12 m/s vs. 0.52 ± 0.15 m/s, P < 0.05* [* means P < 0.05 significant]) and higher gait symmetry (89.2 ± 4.1% vs. 76.5 ± 5.8%, P < 0.01). Conclusion: The M-PEM framework proved effective in improving both physical and psychological aspects of hip fracture recovery. Its personalised, technology-supported design offers a promising model for integrating mental readiness into surgical care pathways.