Individual Nutrition Therapy and Exercise Regime: A Controlled Trial of Injured, Vulnerable Elderly (INTERACTIVE trial).

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Hip fractures are a common and growing problem for older Australians. Unfortunately recovery is incomplete in most people. In this study two factors believed to be important for recovery will be investigated - exercise and nutrition. After a hip fracture the ability to walk is severely compromised, as are appetite and dietary intake. These factors are likely to contribute to the loss of muscle mass and strength frequently observed amongst this patient group. There is considerable evidence to suggest that this loss has serious consequences in terms of ability to return to pre-injury levels of function, restriction in independence and ultimately transfer into a hostel or nursing home. Given these facts it makes sense that an exercise program incorporating strength and functional activities, and a nutrition program aimed at achieving nutritional requirements, will improve ability to walk, but there is no conclusive evidence that this is so. Only a small number of studies have tested whether an exercise program improves recovery after a hip fracture and these have mostly commenced weeks or months after the injury when it is likely that there has been irreversible decline in muscle mass and strength. In contrast, most of the nutrition studies commence soon after the injury but provide protein and calories insufficient to meet requirements, provide supplements that patients find difficult to drink or provide the supplements for only a short duration. This study will use the best quality research methods to test whether providing a 6-month individualised exercise and nutrition program to hip fracture patients soon after injury improves walking and other important health outcomes. Patients will be followed for 12 months to determine what difference the exercise and nutrition programs make. If they help then health services will have the evidence they need to recommend this type of program to the growing number of older Australians that suffer a hip fracture.