Grant: Travel Awards - Institute Community Support

Yearly, around 400 000 Canadian community-dwelling seniors sustain injuries that are not life threatening but limit their mobility & normal activities. Around 65% of these seniors seek care in emergency departments (EDs), and 75% are discharged home from EDs with various minor injuries (75% caused by falls). The Canadian Emergency Team Initiative (CETI) has shown that these injuries can trigger a downward spiral of functional decline in 16% of previously independent seniors up to six months post-injury, unmasking early signs of impairments and frailty. As there is no standard approach to risk assessment & prevention for subsequent decline to use for independent seniors with minor injuries in EDs, their functional status do deteriorate within 6 months post-ED discharge. This is unfortunate as strong evidences on the effectiveness of community or home-based interventions show that interventions, such as fall prevention and exercise-based programs, can prevent frailty & functional limitations. In that context, the CETI has validated a Clinical Decision Rule (CETI-CDR) for ED professionals to screen seniors at high, moderate or low risk of functional decline after a minor injury, and orient them to appropriate post-ED follow-ups. The current project aims at assessing the effects of home or community-based exercise programs vs usual ED discharge in both moderate & high risk seniors. It is hypothesized that seniors with minor injuries who will receive an exercise-based intervention after being released from the ED will experience less functional decline, and have higher physical functions and a better frailty status 3 months post injury than the control group. The project is part of the CIHR-funded CEDeCOMs (Connecting Emergency Departments with Community services to prevent mobility losses in Seniors) multi-center trial, aiming to implement the CETI-CDR to link moderate & high risk seniors to exercise-based programs directly from 7 canadian EDs .