Are three shorter sessions of physiotherapy each therapy day more effective than one longer session in improving the mobility of patients admitted to a rehabilitation ward after hip fracture?

INTERVENTION: This study investigates a new model of physiotherapy rehabilitation for patients admitted to inpatient rehabilitation at the Peter James Centre after surgery for a fractured hip. It is a randomised controlled trial consisting of an intervention group and a control group. The intervention group will receive 3x 15 minute sessions of physiotherapy 5 days/week and the control group will receive usual care of 1x 45 minute session of physiotherapy 5 days/week. This will commence after admission to inpatient rehabilitation and continue until discharge from inpatient rehabilitation. The physiotherapy for both groups will consist of walking practice, therapeutic exercises and functional task practice. Only frequency and duration of sessions will be different between the two groups. Physiotherapy treatment records will be used to assess fidelity/compliance and content of the program. Separate physiotherapists and allied health assistants with a range of experience levels will independently deliver the program to the intervention and control groups. Information sessions and training will be provided to these staff by the principal researcher. Any new staff commencing during the study period will also be trained. Adherence to the protocol will be ensured by the principal researcher with weekly physiotherapy treatment record checks. CONDITION: fractured hip PRIMARY OUTCOME: De Morton Mobility Index (DEMMI) score SECONDARY OUTCOME: 30 day readmission rate to hospital Adverse events for both groups eg falls, infections, death Compliance with the protocol as recorded in the physiotherapy treatment record ie did they participate in all sessions as planned according to their treatment group Daily Functional Independence Measure (FIM) score for ambulation Discharge destination eg.; back to prior residence, need for extra assistance, transition care program, respite or new placement in residential care FIM score for stairs FIM score for transfers (composite score) Length of stay in inpatient rehabilitation (days) Length of stay in the acute hospital (days) Patient satisfaction with the intervention as determined by a survey. This survey was designed for the study and is attached to the original ANZCTR record. Staff satisfaction with the intervention method as determined by a survey. This was designed for the study and is attached to the original ANZCTR record. Total amount of walking daily as determined by an ActivPAL 3 activity monitor INCLUSION CRITERIA: Admitted to the rehabilitation unit at Peter James Centre Primary diagnosis of fractured hip No co‐current injuries Over 50 years of age