Patients’ experiences and preferences for rehabilitation following an ankle fracture

Abstract

Background To explore patients’ experiences of a physiotherapy rehabilitation following an ankle fracture and understand their preferences for how rehabilitation should be organised. Methods We included 13 participants who all suffered an ankle fracture. Semi-structured interviews were conducted 9–26 weeks after the fracture they started rehabilitation. Participants were all from one region of Denmark and were identified using the medical documentation system. Interviews followed an interview guide and were conducted and recorded online and then transcribed verbatim. Two researchers used reflexive thematic analysis to generate themes. Results Thirteen participants were interviewed, nine of whom were female. The age ranged from 46 to 69 years with a median of 60 years. Four major themes and four subthemes were generated: Transfer from the hospital to the physiotherapeutic rehabilitation, Structure and content (subthemes: Shared decision making, Goals and monitoring of progress, Termination of the rehabilitation), Information, instruction and communication (subtheme: Change in physiotherapist) and Subgroups. Participants in an ideal rehabilitation program involved prompt initiation of rehabilitation after plaster/boot removal, effective information dissemination and communication, personalised treatment, and continued care from the same physiotherapist. In an optimal rehabilitation, the participants preferred an early rehabilitation after removing boot/plaster, individualised treatment including thorough information and customised communication and having only one physiotherapist during the rehabilitation. Conclusions This study demonstrates the heterogeneity of rehabilitation experiences following an ankle fracture. Tasked to design rehabilitation to meet their preferences, participants described several common themes and some individual preferences which highlights the need for person-centred physiotherapy. These results enable a deeper understanding of the important factors during rehabilitation after an ankle fracture and can assist clinicians and policy makers to optimise rehabilitation following an ankle fracture.