Optimising mobility after ankle fracture in older adults: a multi-centre pilot randomised controlled trial
Ankle fracture
This is a multicentre pilot randomised controlled trial with an embedded qualitative study. Participants will be allocated to best practice advice (one session of face-to-face advice delivered by a physiotherapist, with up to two additional sessions face-to-face or over the telephone) or progressive functional exercise (up to six sessions of individual face-to-face physiotherapy). After consent participants will be randomised to either best practice advice or progressive exercise. For those randomised to the best practice advice group - these individuals will have 1 session with a physiotherapist and be given lots of advice, with the option if required of having up to 2 follow up sessions - this will end their intervention. For those randomised to the progressive exercise group - these individuals will have up to 6 sessions with a physiotherapist (depending upon their progress) of exercises and assessments - this will end their intervention. Then for both groups at 3 and 6 months participants will be asked to complete questionnaires. At 3 months the questionnaire will be administered via the post/email, whereas at 6 months the questionnaire will be administered either via the post/email or at the follow-up visit participants are asked to attend - where they will have a few standard functional tests administered. There will also be a sub-study within the trial where we hope to interview up to 10 of the participants on their views about the study. This would involve a one to one interview for patients - which would most commonly take place in their home.
1. Adults aged 50 years or over with an ankle fracture 2. Undergoing surgical fixation, or conservative management involving ankle immobilisation for at least 4 weeks
Patients who: 1. Are unable to understand spoken and written English 2. Do not have capacity to consent to study participation 3. Who were not ambulatory prior to the injury 4. Who are considered inappropriate for referral to physiotherapy (in the opinion of the clinician) 5. Who are unable to attend outpatient physiotherapy at a participating centre 6. With serious concomitant disease (such as terminal illness) 7. With avulsion fractures or other fractures not requiring surgery or immobilisation for definitive management 8. With bilateral lower limb fractures