Additional physiotherapy reduced the rate of falls and supplementation with high dose vitamin D3 therapy reduced the rate of hospital readmission. These two interventions may be useful together as they address two distinct but important complications after hip facture. Hip fractures are predicted to increase

in incidence by 36% by 2051 in Australia (Sanders et al 1999). Studies aiming to improve outcomes in this group with effective and relatively low cost interventions have potentially substantial impact for the individual, their family, and costs to the health system. This study is a valuable addition to the limited evidence regarding effective interventions in reducing falls or improving associated outcomes in this high DZNeP risk group. Importantly, this study adds to the substantial evidence available that exercise programs can reduce falls in at-risk older people, although few of these studies have investigated high risk clinical groups such as patients with hip fracture or stroke. The 25% reduction in falls, and a non-significant although substantial reduction in hospitalisations, and Afatinib chemical structure hip fracture-related hospitalisations are impressive outcomes. One critical element for physiotherapists is the content of the exercise program (Hill and Williams 2009), particularly given the findings of a recent meta-analysis that a critical element

of successful fall prevention exercise programs is that they incorporate challenges to the balance system (Sherrington et al 2008). In the brief description of the exercise program in this paper, there appears to be limited focus on balance (‘standing on both legs then standing on one leg while holding Oxalosuccinic acid a handrail’). Other successful falls prevention exercise programs such as the Otago program (Robertson et al 2002) have incorporated a stronger focus on specific balance activities. Given that falls in most cases caused the hip fracture in these patients, and balance impairment is strongly implicated in falls, it will be worth investigating if stronger focus on

balance performance can achieve even better outcomes. “
“Summary of: Bleakley CM, O’Connor SR, Tully MA, Rocke LG, MacAuley D, Bradbury I, et al (2010) Effect of accelerated rehabilitation on function after ankle sprain: randomised controlled trial. BMJ 340: c1964 doi:10.1136/bmj.c1964 [Prepared by Margreth Grotle and Kåre Birger Hagen, CAP Editors.] Question: What is the effect of an accelerated intervention incorporating early therapeutic exercise as compared to a standard intervention of protection, rest, ice, compression, and elevation after acute ankle sprain? Design: Randomised, controlled trial with blinded outcome assessment and intention-to-treat analysis. Setting: An emergency department and sports injury clinic in Northern Ireland. Participants: Men and women 16–65 years, with acute (< 7 days) grade 1 or 2 ankle sprain.