RESTORE: Recovery exercises and Stepping On after fracture.

Participants randomised to the intervention group will receive home visits of 45-60 minutes duration from a physiotherapist. The physiotherapist will prescribe an individualised exercise program and use motivational interviewing and goal setting to encourage behaviour change with regard to exercise. The physiotherapists will conduct ten home visits throughout the 12-month study period and provide fortnightly phone calls. Participants will be encouraged to continue the exercises three times weekly at home. The program will involve the following features: exercise will be individually prescribed based on assessment of physical abilities; there will be an emphasis on functionally-relevant weight-bearing exercise designed primarily to reduce falls and disability by enhancing balance and functional abilities; and exercises will include repetitions of the sit-to-stand movement, semisquats from a standing position, reaching in standing, forward, backward and sideways walking and stepping up onto blocks. The exercise intervention is suitable for people after lower limb or pelvic fracture on the basis of previous work led by Investigators Sherrington, Moseley, Lord and Cameron. Intervention group participants will also be offered fall prevention education through individualised advice from the physiotherapist or attendance at the group based “Stepping On” program. The Stepping On program was developed by Chief Investigator Clemson as implemented by the NSW Department of Health: weekly 2-hour group discussion sessions for seven weeks. The Stepping On content will be relevant to people with fall-related lower limb or pelvic fracture and will cover coping with visual loss and regular visual screening, medication management, environmental and behavioural home safety, and community safety. Group sessions will be held in rooms at local community centres or hospitals. Transport will be provided for those who would otherwise be unable to attend the sessions. Each program will be attended by up to 13 people. The group sessions will be facilitated by a occupational therapist or other health professional. The group sessions will be completed within the 12-month study period, with the timing depending on availability of a Stepping On program. Individualised fall prevention advice from the study physiotherapists will cover similar topic areas and will provided to participants who are unable or unwilling to attend the Stepping On groups, those for whom no local group is available and those who do not meet eligibility criteria for the NSW health Stepping On programs eg those who use walking aids. The individualised fall prevention advice will be provided at each physiotherapy home visit.