‘Functional Freedom for Fallers with Fractures’ – where do we invest intervention to maximise outcomes for our consumers

Mr Nicholas Davis1

1Central Coast Local Health District,

With approximately 1 in 3 Australians aged 65 and over falling every year, and up to 6% of these suffering a fracture, the resulting functional restriction can often result in devastating outcomes. Our service wanted to determine what aspects of client intervention we should be investing in.

We collated post intervention observational data from 121 consumers of the Transitional Aged Care Program (TACP) Central Coast Local Health District (CCLHD) who had fallen, suffered a fracture, and required surgical intervention, to determine the significance of measured predictors and variables on function via statistical analysis (January 2017 to June 2018). Functional outcome measures analysed included consumer identified mobility and falls specific goals, the DeMorton Mobility Index (DEMMI), the Modified Barthel Index (MBI), and exercise tolerance. We also investigated the impact of mild to moderate cognitive impairment on functional outcomes, and whether certain covariates are statistically significant (including sex, age, duration of intervention, carer and family assistance, service provider assistance and home exercise compliance). A Lightening Oral Presentation with accompanying ePoster will summarise outcomes and key learning for future practice and research.

Early results of statistical analysis, via linear and mixed effects regression modelling, have highlighted that functional improvements (via the DEMMI) for consumers with mild-moderate cognitive impairment are significantly less than consumers without cognitive impairment. Furthermore, whilst a negative association exists with identified mild-moderate cognitive impairment, this did not reach statistical significance in relation to goal attainment and the MBI. Current results show that duration of intervention, family assistance and the interaction of mild-moderate cognitive impairment and time had a significant effect on exercise tolerance, with a statistically significant difference between groups. Further analysis underway will identify significance of other covariates (carer, family, and/or service provider assistance with exercise, and exercise compliance) for presentation.


Nicholas Davis, Senior Physiotherapist, Transitional Aged Care Program, Central Coast Local Health District

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