Cargando…

Study on proximal humerus evaluation of effective treatment (SPHEER) – what is the effect of rehabilitation compliance on clinical outcomes of proximal humerus fractures

INTRODUCTION: Proximal humeral fractures (PHFs) are 3(rd) commonest fragility fractures and cause significant functional impairment. This paper sought to determine impact of rehabilitation compliance on the clinical outcomes for non-surgically managed PHFs, while ascertaining reasons for non-complia...

Descripción completa

Detalles Bibliográficos
Autores principales: Nah, Ming Foo Kenneth, Pereira, Michelle Jessica, Hemaavathi, Mani, Wong, Shiyun Winnie, Lim, Chien Joo, Tan, Bryan Yijia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544385/
https://www.ncbi.nlm.nih.gov/pubmed/37784126
http://dx.doi.org/10.1186/s12891-023-06894-w
_version_ 1785114495121620992
author Nah, Ming Foo Kenneth
Pereira, Michelle Jessica
Hemaavathi, Mani
Wong, Shiyun Winnie
Lim, Chien Joo
Tan, Bryan Yijia
author_facet Nah, Ming Foo Kenneth
Pereira, Michelle Jessica
Hemaavathi, Mani
Wong, Shiyun Winnie
Lim, Chien Joo
Tan, Bryan Yijia
author_sort Nah, Ming Foo Kenneth
collection PubMed
description INTRODUCTION: Proximal humeral fractures (PHFs) are 3(rd) commonest fragility fractures and cause significant functional impairment. This paper sought to determine impact of rehabilitation compliance on the clinical outcomes for non-surgically managed PHFs, while ascertaining reasons for non-compliance which can be addressed to improve compliance. METHODS: Prospective cohort study of patients undergoing non-surgical treatment for PHFs from August 2017 to April 2020 in a tertiary trauma centre was performed. Data was collected via questionnaire: patient demographic data, PHF injury details, clinical outcome measures, therapist-reported (Sport Injury Rehabilitation Adherence Scale [SIRAS]) and patient-reported (subjective compliance, frequency of exercise) rehabilitation compliance measures. Data was analysed using multiple linear regression model to account for confounding variables. RESULTS: 107 participants attended physical therapy follow-up for mean 137.8 days. 6-week SIRAS strongly predicted 3-month Constant score (p = 0.023; 95%CI = 0.265,3.423), OSS (p = 0.038; 95%CI = 0.049,1.634), flexion ROM (p < 0.001; 95%CI = 2.872,8.982), extension ROM (p = 0.035; 95%CI = 0.097,2.614), abduction ROM (p = 0.002;95%CI = 1.995,8.466) and achievement of functional active ROM at 3-months (p = 0.049; 95%CI = 1.001,1.638). Pain was the top reason impairing rehabilitation compliance from therapist (43.9% at 6-weeks and 20.6% at 3-months) and patient-perspective (33.6% at 6-weeks, 24.3% at 3-months). Author-developed patient-reported compliance measures had good correlation with validated SIRAS score (subjective compliance: p < 0.001 frequency of exercise: p = 0.001). CONCLUSION: Rehabilitation compliance predicts short-term clinical outcomes up to 3-months and potentially 1-year outcomes. Pain control should be optimised to maximise rehabilitation compliance and improve PHF outcomes. There is lack of consensus definition for rehabilitation compliance measures; patient-reported measures used have good correlation to existing validated measures and could serve as a steppingstone for further research. LEVEL OF EVIDENCE: II, cohort study. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-023-06894-w.
format Online
Article
Text
id pubmed-10544385
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-105443852023-10-03 Study on proximal humerus evaluation of effective treatment (SPHEER) – what is the effect of rehabilitation compliance on clinical outcomes of proximal humerus fractures Nah, Ming Foo Kenneth Pereira, Michelle Jessica Hemaavathi, Mani Wong, Shiyun Winnie Lim, Chien Joo Tan, Bryan Yijia BMC Musculoskelet Disord Research INTRODUCTION: Proximal humeral fractures (PHFs) are 3(rd) commonest fragility fractures and cause significant functional impairment. This paper sought to determine impact of rehabilitation compliance on the clinical outcomes for non-surgically managed PHFs, while ascertaining reasons for non-compliance which can be addressed to improve compliance. METHODS: Prospective cohort study of patients undergoing non-surgical treatment for PHFs from August 2017 to April 2020 in a tertiary trauma centre was performed. Data was collected via questionnaire: patient demographic data, PHF injury details, clinical outcome measures, therapist-reported (Sport Injury Rehabilitation Adherence Scale [SIRAS]) and patient-reported (subjective compliance, frequency of exercise) rehabilitation compliance measures. Data was analysed using multiple linear regression model to account for confounding variables. RESULTS: 107 participants attended physical therapy follow-up for mean 137.8 days. 6-week SIRAS strongly predicted 3-month Constant score (p = 0.023; 95%CI = 0.265,3.423), OSS (p = 0.038; 95%CI = 0.049,1.634), flexion ROM (p < 0.001; 95%CI = 2.872,8.982), extension ROM (p = 0.035; 95%CI = 0.097,2.614), abduction ROM (p = 0.002;95%CI = 1.995,8.466) and achievement of functional active ROM at 3-months (p = 0.049; 95%CI = 1.001,1.638). Pain was the top reason impairing rehabilitation compliance from therapist (43.9% at 6-weeks and 20.6% at 3-months) and patient-perspective (33.6% at 6-weeks, 24.3% at 3-months). Author-developed patient-reported compliance measures had good correlation with validated SIRAS score (subjective compliance: p < 0.001 frequency of exercise: p = 0.001). CONCLUSION: Rehabilitation compliance predicts short-term clinical outcomes up to 3-months and potentially 1-year outcomes. Pain control should be optimised to maximise rehabilitation compliance and improve PHF outcomes. There is lack of consensus definition for rehabilitation compliance measures; patient-reported measures used have good correlation to existing validated measures and could serve as a steppingstone for further research. LEVEL OF EVIDENCE: II, cohort study. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-023-06894-w. BioMed Central 2023-10-02 /pmc/articles/PMC10544385/ /pubmed/37784126 http://dx.doi.org/10.1186/s12891-023-06894-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Nah, Ming Foo Kenneth
Pereira, Michelle Jessica
Hemaavathi, Mani
Wong, Shiyun Winnie
Lim, Chien Joo
Tan, Bryan Yijia
Study on proximal humerus evaluation of effective treatment (SPHEER) – what is the effect of rehabilitation compliance on clinical outcomes of proximal humerus fractures
title Study on proximal humerus evaluation of effective treatment (SPHEER) – what is the effect of rehabilitation compliance on clinical outcomes of proximal humerus fractures
title_full Study on proximal humerus evaluation of effective treatment (SPHEER) – what is the effect of rehabilitation compliance on clinical outcomes of proximal humerus fractures
title_fullStr Study on proximal humerus evaluation of effective treatment (SPHEER) – what is the effect of rehabilitation compliance on clinical outcomes of proximal humerus fractures
title_full_unstemmed Study on proximal humerus evaluation of effective treatment (SPHEER) – what is the effect of rehabilitation compliance on clinical outcomes of proximal humerus fractures
title_short Study on proximal humerus evaluation of effective treatment (SPHEER) – what is the effect of rehabilitation compliance on clinical outcomes of proximal humerus fractures
title_sort study on proximal humerus evaluation of effective treatment (spheer) – what is the effect of rehabilitation compliance on clinical outcomes of proximal humerus fractures
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544385/
https://www.ncbi.nlm.nih.gov/pubmed/37784126
http://dx.doi.org/10.1186/s12891-023-06894-w
work_keys_str_mv AT nahmingfookenneth studyonproximalhumerusevaluationofeffectivetreatmentspheerwhatistheeffectofrehabilitationcomplianceonclinicaloutcomesofproximalhumerusfractures
AT pereiramichellejessica studyonproximalhumerusevaluationofeffectivetreatmentspheerwhatistheeffectofrehabilitationcomplianceonclinicaloutcomesofproximalhumerusfractures
AT hemaavathimani studyonproximalhumerusevaluationofeffectivetreatmentspheerwhatistheeffectofrehabilitationcomplianceonclinicaloutcomesofproximalhumerusfractures
AT wongshiyunwinnie studyonproximalhumerusevaluationofeffectivetreatmentspheerwhatistheeffectofrehabilitationcomplianceonclinicaloutcomesofproximalhumerusfractures
AT limchienjoo studyonproximalhumerusevaluationofeffectivetreatmentspheerwhatistheeffectofrehabilitationcomplianceonclinicaloutcomesofproximalhumerusfractures
AT tanbryanyijia studyonproximalhumerusevaluationofeffectivetreatmentspheerwhatistheeffectofrehabilitationcomplianceonclinicaloutcomesofproximalhumerusfractures