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

髋部骨折对澳大利亚老年人来说是一个常见且日益严重的问题。不幸的是，大多数人的康复是不完全的。在这项研究中，我们将调查运动和营养这两个对恢复很重要的因素。髋部骨折后，行走能力严重受损，食欲和饮食摄入也严重受损。这些因素很可能导致肌肉质量和力量的损失，经常在这个病人群体中观察到。有相当多的证据表明，这种损失对恢复到受伤前的功能水平的能力、独立性的限制以及最终转移到旅馆或养老院有严重的后果。考虑到这些事实，结合力量和功能性活动的锻炼计划，以及旨在满足营养需求的营养计划，将提高行走能力，这是有道理的，但没有确凿的证据证明这一点。只有少数研究测试了锻炼计划是否能促进髋部骨折后的恢复，这些研究大多是在受伤后几周或几个月开始的，此时肌肉质量和力量可能已经出现了不可逆转的下降。相比之下，大多数营养研究在受伤后不久就开始了，但提供的蛋白质和卡路里不足以满足需求，提供的补充剂使患者难以饮用，或者只提供短时间的补充剂。这项研究将使用最优质的研究方法来测试是否为髋部骨折患者提供6个月的个性化运动和营养计划，以改善步行和其他重要的健康结果。患者将被跟踪12个月，以确定运动和营养计划有什么不同。如果他们有所帮助，那么卫生服务机构将有证据向越来越多的患髋部骨折的澳大利亚老年人推荐这类项目。

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.