HIP fracture Supplemental Therapy to Enhance Recovery

INTERVENTION: Participants in the intervention group will receive usual care physiotherapy as per the control treatment, plus two additional daily sessions. One session will be delivered by an allied health assistant, to practice the achievements of the usual care session. The other session will be delivered by a physiotherapist and targeted to the needs of the patient with the aim of progressing the functional gains achieved in the previous therapy session including increasing independence with mobility, progression of gait aid (e.g. frame to crutches) and increasing the distance walked. We anticipate that the sessions will be approximately 30 minutes each although will be targeted to the patient and their ability to participate. The sessions will be at least 2 hours apart to allow time for the patient to rest in between sessions. The intervention will be delivered for 7 days or until discharge from the acute ward, whichever occurs sooner. The occasions of service and length of each treatment session will be recorded to monitor adherence to the intervention. Participants in the intervention group will also receive medical and surgical management according to best practice standards. Allied health interventions aside from physiotherapy (e.g. occupational therapy) will be delivered according to usual practice at each centre with all encounters recorded. CONDITION: Hip fracture; ; Hip fracture Injuries and Accidents ‐ Fractures Musculoskeletal ‐ Other muscular and skeletal disorders Physical Medicine / Rehabilitation ‐ Physiotherapy PRIMARY OUTCOME: Total hospital length of stay for the index admission in days, including both acute hospital days and rehabilitation hospital days. This will be collected via review of the medical records.[Discharge from the hospital stay, including rehabilitation/sub‐acute care stay if that is the discharge destination from the acute hospital. T] INCLUSION CRITERIA: Aged 65 years or older and admitted with an isolated subcapital or intertrochanteric hip fracture subsequently managed operatively SECONDARY OUTCOME: Discharge destination from the acute ward assessed by Australian and NZ Hip Fracture Registry data and via review of hospital medical record[At discharge from the acute ward] Falls efficacy measured with the Falls Efficacy Scale‐International (FES‐I) via telephone interview with participant [At day 7, 6 weeks, 120 days and 12 months post hip fracture surgery ] Functional mobility measured with the Modified Iowa Level of Assistance Score (mILOA) via assessment by blinded assessor[At day 7 post‐surgery ] Health related quality of life measured with the EuroQol EQ‐5D‐5L via in person (day7) or telephone interview with participant[At day 7 (in person), 6 weeks, 120 days and 12 months post hip fracture surgery ] Health related quality of life measured with the ICEpop CAPability measure for Older people (ICECAP‐O) via in person (day 7) and telephone interview with participant [At day 7 , 6 weeks, 120 days and 12 months post hip fracture surgery ] Healthcare utilisation, assessed by patient‐reported data via monthly telephone interview with participants as well as a phone call at 6 weeks, 120 days and 12 months, review of hospital records and Medicare Benefits Schedule (MBS) / Pharmaceutical Benefits Scheme (PBS) data[At 12 months following hip fracture surgery ] Number of adverse events as defined by Good Clinical Practice (GCP) standards. Examples of adverse events may include inpatient falls or dislocation of hip prosthesis, as well as hospital readmission. This will be collected via via phone interviews with participant and a review of medical records[At 6 weeks, 120 days and 12 months post hip fracture surgery ] Number of falls assessed by patient report via phone interviews with participant and a review of medical records[The data will be collated at 6 weeks, 120 days and 12 months post hip fracture surgery] Participant current residence as assessed by by Australian and NZ Hip Fracture Registry data and patient‐reported data via phone interviews with participant and a review of medical records[At 6 weeks, 120 days and 12 months post hip fracture surgery] Proportion of patients remaining in hospital assessed by medical records[At 6 weeks post hip fracture surgery] Re‐operation rate as assessed by by Australian and NZ Hip Fracture Registry data, patient‐reported data via phone interviews with participant and a review of medical records[At 6 weeks, 120 days and 12 months post hip fracture surgery] Return to preadmission mobility assessed by by Australian and NZ Hip Fracture Registry data and patient report ‐ undertaken via telephone interview with the participant [At 6 weeks, 120 days and 12 months post hip fracture surgery] Survival assessed by Australian and NZ Hip Fracture Registry data and review of hospital records[At 6 weeks, 120 days and 12 months post hip fracture surgery]