Rehabilitation Prescription Allowing Injury Recovery (RePAIR) – RCT

Studies of medium-to long-term recovery have shown that functional and quality-of-life outcomes of trauma patients who survive to hospital discharge are substantially influenced by post-hospital treatments, care and support. In India and some parts of Australia, physical, cognitive and other rehabilitation resources are often unavailable, or are piecemeal, poorly organised, and difficult to access. Where no services are available, the majority of rehabilitation may be delivered by family, but there is no available evidence on effectiveness of such approaches. The aim of the AITSC rehabilitation intervention was to evaluate the effect of a home-based physiotherapy rehabilitation program for trauma patients with lower limb fractures on functional outcomes, post-discharge complications and quality of life, in three Indian trauma centres. In 2015 –2016 an observational study was conducted in three sites in 300 patients, to establish standard care in India for adults with lower limb fractures showed poor functional outcomes at 6 weeks in all age groups that marginally improved at 12 weeks. Following the observational study a paper-based rehabilitation prescription for adults with lower limb fractures was developed, based on the physiotherapy exercise manual used at the Alfred, adapted for Indian setting by investigative team. A prospective randomised controlled trial (RCT) of this paper-based prescription (the RePAIR trial) was commenced in 2017 in three Indian hospitals. The RePAIR trial aims to evaluate the effect of this prescription on functional outcomes, post-discharge complications and quality of life. The RePAIR trial concluded in the middle of 2018. The results of the observational study and RCT will be the subject of two peer-reviewed publications in 2019.