Effect of Individual Nutrition Therapy and Exercise Regime on Gait Speed, Physical Function, Strength and Balance, Body Composition, Energy and Protein, in Injured, Vulnerable Elderly: A Multisite Randomized Controlled Trial (INTERACTIVE).

It is imperative that the surgical treatment of hip fractures is followed up with rehabilitation to enhance recovery and quality of life. This randomized controlled trial aimed to determine if an individualised, combined exercise-nutrition intervention significantly improved health outcomes in older adults, after proximal femoral fracture. We commenced the community extended therapy while in hospital, within two weeks post-surgery.

Cost-effectiveness of individualized nutrition and exercise therapy for rehabilitation following hip fracture.

Objective: To undertake a cost-utility analysis of the Individual Nutrition Therapy and Exercise Regime: A Controlled Trial of Injured, Vulnerable Elderly (INTERACTIVE) trial.

Design: Cost-utility analysis of a randomized controlled trial.

Subjects: A total of 175 patients following a hip fracture were allocated to receive either alternate weekly visits from a physical therapist and dietitian (intervention group), or social visits for 6 months (control group).

Improvement of Physical Therapist Assessment of Risk of Falls in the Hospital and Discharge Handover Through an Intervention to Modify Clinical Behavior.

Background: Discharge from the hospital is a high risk transition period for older adults at risk of falls. Guidelines relevant to physical therapists for managing this risk are well documented, but commonly not implemented.

Purpose: This project implemented an intervention to improve physical therapists' adherence to key guideline recommendations for managing risk of falls on discharge from one hospital.

A head-to-head comparison of the de Morton Mobility Index (DEMMI) and Elderly Mobility Scale (EMS) in an older acute medical population.

Purpose: To compare the clinimetric properties of the de Morton Mobility Index (DEMMI®) and the Elderly Mobility Scale (EMS).

Method: A head-to-head comparison of the EMS and DEMMI® with 120 consecutive older acute medical patients. The DEMMI® and EMS were administered within 48 h of hospital admission and discharge.

Virtual reality for stroke rehabilitation.

Background: Virtual reality and interactive video gaming have emerged as recent treatment approaches in stroke rehabilitation. In particular, commercial gaming consoles have been rapidly adopted in clinical settings. This is an update of a Cochrane Review published in 2011.

Use of the theoretical domains framework to develop an intervention to improve physical therapist management of the risk of falls after discharge.

Background And Purpose: Older adults have an increased risk of falls after discharge from the hospital. Guidelines to manage this risk of falls are well documented but are not commonly implemented. The aim of this case report is to describe the novel approach of using the Theoretical Domains Framework (TDF) to develop an intervention to change the clinical behavior of physical therapists.

Sociodemographic factors associated with self-reported exercise and physical activity behaviors and attitudes of South Australians: results of a population-based survey.

Objective: To determine self-reported physical activity barriers, behaviors, and beliefs about exercise of a representative sample and to identify associated sociodemographic factors.

Method: Face-to-face interviews conducted between September and December 2008, using a random stratified sampling technique.

Results: Barriers injury and illness were associated with being older, single, and not engaged in full-time work; lack of time was associated with being married, younger, female, and working full-time; and lack of motivation and cost were associated with being younger than 65 years.

Virtual reality for stroke rehabilitation.

Background: Virtual reality and interactive video gaming have emerged as new treatment approaches in stroke rehabilitation. In particular, commercial gaming consoles are being rapidly adopted in clinical settings; however, there is currently little information about their effectiveness.

Objectives: To evaluate the effects of virtual reality and interactive video gaming on upper limb, lower limb and global motor function after stroke.

Determining current physical therapist management of hip fracture in an acute care hospital and physical therapists' rationale for this management.

Background: Physical therapy has an important role in hip fracture rehabilitation to address issues of mobility and function, yet current best practice guidelines fail to make recommendations for specific physical therapy interventions beyond the first 24 hours postsurgery.

Objectives: The aims of this study were: (1) to gain an understanding of current physical therapist practice in an Australian acute care setting and (2) to determine what physical therapists consider to be best practice physical therapist management and their rationale for their assessment and treatment techniques.

Design And Methods: Three focus group interviews were conducted with physical therapists and physical therapist students, as well as a retrospective case note audit of 51 patients who had undergone surgery for hip fracture.

Walking aid use after discharge following hip fracture is rarely reviewed and often inappropriate: an observational study.

Questions: What walking aid prescription occurs at discharge after hip fracture? What changes in walking aid use occur in the following six months? Who initiates changes in walking aids and why?

Design: Prospective longitudinal observational study.

Participants: 95 community-dwelling older adults who had undergone surgical treatment of a hip fracture.

Outcome Measures: Range of walking aids prescribed at discharge and participants' recall of advice about progression were recorded.

Does the 'Otago exercise programme' reduce mortality and falls in older adults?: a systematic review and meta-analysis.

Background: the 'Otago exercise programme' (OEP) is a strength and balance retraining programme designed to prevent falls in older people living in the community. The aim of this review was to evaluate the effect of the OEP on the risk of death and fall rates and to explore levels of compliance with the OEP in older adults.

Methods: a systematic review with meta-analysis.

Falls Clinics: an opportunity to address frailty and improve health outcomes (preliminary evidence).

Background And Aim: Currently the operational model of a Falls Clinic is not clearly defined making it difficult to assess outcomes. Predominantly referrals are for older, frail adults and while there is merit in current interventions prescribed the effect on falls and other outcomes over time are unclear. The aim of this pilot study is to describe 12 month health outcomes of community-dwelling older adults who have attended a multi-disciplinary Falls Clinic.

Targeted individual exercise programmes for older medical patients are feasible, and may change hospital and patient outcomes: a service improvement project.

Background: The aim of this project was primarily to assess the feasibility of individual exercise programs for older hospitalised patients at risk of functional decline, and secondarily to evaluate impact on discharge outcomes.

Design: Cohort service improvement project.

Setting: 500 bed acute metropolitan hospital.

Individual nutrition therapy and exercise regime: a controlled trial of injured, vulnerable elderly (INTERACTIVE trial).

Background: Proximal femoral fractures are amongst the most devastating consequences of osteoporosis and injurious accidental falls with 25-35% of patients dying in the first year post-fracture. Effective rehabilitation strategies are evolving however, despite established associations between nutrition, mobility, strength and strength-related functional outcomes; there has been only one small study with older adults immediately following fragility fracture where a combination of both exercise and nutrition have been provided. The aim of the INTERACTIVE trial is to establish whether a six month, individualised exercise and nutrition program commencing within fourteen days of surgery for proximal femur fracture, results in clinically and statistically significant improvements in physical function, body composition and quality of life at an acceptable level of cost and resource use and without increasing the burden of caregivers.