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Randomized Controlled Trial
. 2020 Oct;35(10):2907-2916.
doi: 10.1007/s11606-020-05666-9. Epub 2020 Feb 3.

Exercise to Reduce Mobility Disability and Prevent Falls After Fall-Related Leg or Pelvic Fracture: RESTORE Randomized Controlled Trial

Catherine Sherrington  1 , Nicola Fairhall  2 , Catherine Kirkham  2 , Lindy Clemson  3 , Anne Tiedemann  2 , Constance Vogler  4   5 , Jacqueline C T Close  6   7 , Sandra O'Rourke  2   7 , Anne M Moseley  2 , Ian D Cameron  8 , Jenson C S Mak  8   9 , Stephen R Lord  7
Affiliations
Randomized Controlled Trial

Exercise to Reduce Mobility Disability and Prevent Falls After Fall-Related Leg or Pelvic Fracture: RESTORE Randomized Controlled Trial

Catherine Sherrington et al. J Gen Intern Med. 2020 Oct.

Abstract

Background: Disability and falls are common following fall-related lower limb and pelvic fractures.

Objective: To evaluate the impact of an exercise self-management intervention on mobility-related disability and falls after lower limb or pelvic fracture.

Design: Randomized controlled trial.

Participants: Three hundred thirty-six community dwellers aged 60+ years within 2 years of lower limb or pelvic fracture recruited from hospitals and community advertising.

Interventions: RESTORE (Recovery Exercises and STepping On afteR fracturE) intervention (individualized, physiotherapist-prescribed home program of weight-bearing balance and strength exercises, fall prevention advice) versus usual care.

Main measures: Primary outcomes were mobility-related disability and rate of falls.

Key results: Primary outcomes were available for 80% of randomized participants. There were no significant between-group differences in mobility-related disability at 12 months measured by (a) Short Physical Performance Battery (continuous version, baseline-adjusted between-group difference 0.08, 95% CI - 0.01 to 0.17, p = 0.08, n = 273); (b) Activity Measure Post Acute Care score (0.18, 95% CI - 2.89 to 3.26, p = 0.91, n = 270); (c) Late Life Disability Instrument (1.37, 95% CI - 2.56 to 5.32, p = 0.49, n = 273); or in rate of falls over the 12-month study period (incidence rate ratio 0.96, 95% CI 0.69 to 1.34, n = 336, p = 0.83). Between-group differences favoring the intervention group were evident in some secondary outcomes: balance and mobility, fall risk (Physiological Profile Assessment tool), physical activity, mood, health and community outings, but these should be interpreted with caution due to risk of chance findings from multiple analyses.

Conclusions: No statistically significant intervention impacts on mobility-related disability and falls were detected, but benefits were seen for secondary measures of balance and mobility, fall risk, physical activity, mood, health, and community outings.

Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12610000805077.

Keywords: exercise; fall prevention; hip fracture; randomized controlled trial.

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Conflict of interest statement

All authors report grants from the Australian National Health and Medical Research Council during the conduct of the study. Prof Lord reports that the physiological profile assessment (FallScreen) is commercially available through NeuRA.

Figures

Figure 1
Figure 1
Overview of the flow of participants.
See this image and copyright information in PMC

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