OBJECTIVE: To compare the effects of weight-bearing and non-weight-bearing home exercise programs and a control program on physical ability (strength, balance, gait, functional performance) in older people who have had a hip fracture. DESIGN: Randomized controlled trial with 4-month follow-up. SETTING: Australian community-dwellers (82%) and residents of aged care facilities who had completed usual care after a fall-related hip fracture. PARTICIPANTS: One hundred twenty older people entered the trial, 40 per group (average age +/- standard deviation, 79 +/- 9 y) and 90% completed the 4-month retest. INTERVENTION: Home exercise prescribed by a physical therapist. Main outcome measures Strength, balance, gait, and functional performance. RESULTS: At the 4-month retest, there were differences between the groups in the extent of improvement since the initial assessment for balance (F[10,196] = 2.82, p < 0.001) and functional performance (F[6,200] = 3.57, p < 0.001), but not for strength (F[12,190] = 1.09, p = 0.37) or gait (F[8,200] = 0.39, p = 0.92). The weight-bearing exercise group showed the greatest improvements in measures of balance and functional performance (between-group differences of 30% to 40% of initial values). CONCLUSIONS: A weight-bearing home exercise program can improve balance and functional ability to a greater extent than a non-weight-bearing program or no intervention among older people who have completed usual care after a fall-related hip fracture.

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