Fracture Rehabilitation Research Articles

Rapid Synthesis of the Literature on the Evolution of Gamification in Distal Radial Fracture Rehabilitation.

Distal radial fractures (DRF) are often encountered in upper limb fractures globally, and their associated complications affect the functional independence of the individual following the injury. The potential of gamification in applied rehabilitation is expanding its horizons in the rehabilitation of conditions ranging from neuromotor deficits to cognitive impairments. However, the synthesis of the literature is aimed at analyzing and summarizing the evolution of gamification in DRF rehabilitation. A comprehensive search and extraction of relevant literature were conducted and reviewed for the applicability of population analysis, interventional methodology, comparative factors, outcome measures, and the type of study. Thirteen studies were included and evaluated, including randomized controlled trials (RCTs), literature reviews, systematic reviews, meta-analyses, and bibliometric analyses. The conclusions demonstrated an improvement with gamification and addressed it as an effective rehabilitation method. Based on the analysis of the data that was extracted, the conclusion supports the use of gamification in the rehabilitation of DRF and looks into how it can help improve the person's functional capacity.

Gamification for Distal Radius Fracture Rehabilitation: A Randomized Controlled Pilot Study

IntroductionGamification is a novel interventional approach to functional recovery and rehabilitation. A significant impact has been observed with the application of gamification on non-traumatic conditions and chronic neurological and musculoskeletal illnesses; however, the implication of gamification on the functional recovery of patients with distal radius fractures (DRF) is yet to be explored. MethodologyThis pilot study included 20 post-DRF patients aged 18-65 years with unilateral DRF, managed with closed reduction and K-wire internal fixation. The patients were assigned to group A (gamification) and group B (conventional rehabilitation) in a 1:1 ratio. Group A patients played Racket: NX game, Until you fall game, and Holofit game on Oculus Quest head-mounted display (HMD) (Oculus, USA), while group B patients received a conventional rehabilitation program. Both groups underwent a rehabilitation program for 60 min/day, five days a week, for four weeks. The visual analogue scale (VAS), universal goniometer, Jamar dynamometer, and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire were used as outcome measures at baseline, at the end of the second week, and at the end of treatment.ResultsThere were significant improvements in pain, range of motion (ROM), grip strength, and functional independence in both groups. However, improvements in hand function and functional independence were significantly greater in the gamification group than in the conventional physiotherapy rehabilitation group.ConclusionThe study concluded that gamification appears to have a significant impact on post-DRF rehabilitation in terms of pain, ROM, grip strength, and functional independence. Further research with larger sample sizes is required to confirm the preliminary findings.

Assessment of the effect of a total contact cast on lower limb kinematics and joint loading

BackgroundTotal contact casts (TCCs) are used to immobilize and unload the foot and ankle for the rehabilitation of ankle fractures and for the management of diabetic foot complications. The kinematic restrictions imposed by TCCs to the foot and ankle also change knee and hip kinematics, however, these changes have not been quantified before. High joint loading is associated with discomfort and increased risk for injuries. To assess joint loading, the effect of the muscle forces acting on each joint must also be considered. This challenge can be overcome with the help of musculoskeletal modelling. Research questionHow does a TCC affect lower extremity joint loading? MethodsTwelve healthy participants performed gait trials with and without a TCC. Kinematic and kinetic recordings served as input to subject-specific musculoskeletal models that enabled the computation of joint angles and loading. Cast-leg interaction was modelled by means of reaction forces between a rigid, zero-mass cast segment and the segments of the lower extremity. Resultsand Significance: Reduced ankle, knee and hip range of motion was observed for the TCC condition. Statistical parametric mapping indicated decreased hip abduction and flexion moments during initial contact with the TCC. The anterior knee force was significantly decreased during the mid and terminal stance and the second peak of the compressive knee force was significantly reduced for the TCC. As expected, the TCC resulted in significantly reduced ankle loading. SignificanceThis study is the first to quantify the effect of a TCC on lower limb joint loading. Its results demonstrate the efficiency of a TCC in unloading the ankle joint complex without increasing the peak loads on knee and hip. Future studies should investigate whether the observed knee and hip kinematic and kinetic differences could lead to discomfort.

Loss of intraflagellar transport 140 in osteoblasts cripples bone fracture healing

The indispensability of primary cilia in skeletal development has been widely recognized. We have previously shown that intraflagellar transport 140 (IFT140), a protein component of a bidirectional intraflagellar transport system required for ciliary function, controls bone development and dentinogenesis. However, it remains unknown whether IFT140 functionally contributes to bone fracture rehabilitation. Here an osteotomy-induced femoral fracture model was generated in Ift140-transgenic (Ift140-TG) and osteoblast-specific Ift140-conditional knockout (Ift140-cKO) mice. Micro-computed tomography, osteogenic induction, qualitative polymerase chain reaction, and toluidine blue and safranin O/fast green staining assays were used to characterize the dynamics of bone fracture healing from various perspectives. We found that IFT140 was relatively enriched in the bone callus and decreased in fracture-susceptible aged, or diabetic bones. Ift140-cKO mice had impaired osteogenic differentiation from bone mesenchymal stem cells, lower bone mass, and delayed fracture closure, whereas Ift140-TG mice had promising healing outcomes. Overall, our findings demonstrated for the first time that IFT140 has a beneficial role in fracture repair. Future investigation of the primary cilium in the context of aging and osteoporosis would certainly benefit patients at high risk of bone fractures.

Effect of virtual reality and conventional physiotherapy on rehabilitation of distal radius fracture

Rehabilitation sometimes may be an uncomfortable and tiring method that incorporates multiple activities and sets of exercises which patients require to perform to achieve good prognosis, for a significant period of time. Unfortunately, most of times the patients frequently become not willing, aggravated, and need inspiration and feel exhausted which makes recovery from the condition will less proficient. Use of the Virtual Reality have been broadly executing into rehabilitation program intends to make the process of recovery more energizing, invigorating and engaging for patients. Within this protocol, we propose to utilization of head wearing gadget name Oculus Quest for patient's wrist recovery after Colle’s fracture. After receiving Institutional Ethical committee approval, we will include 40 Colle’s fracture patients, and randomly divide them in two groups. Further group A will receive conventional physiotherapy treatment and group B will receive treatment from Virtual reality as well as conventional treatment for 4 weeks. Pre and post treatment assessment for Pain, Range of motion and functional parameters will be evaluated. The primary aim study is to check the impact of virtual reality and conventional physiotherapy after Colle’s Fracture. This exploration will help in distinguishing quick and longterm impacts of Virtual reality in DRF patients. The investigation results would assist in forming the newly planned strategies with better prognosis in rehabilitation of patients with Colle’s fracture.

The paradoxical relation between serum uric acid and outcomes of hip fracture in older patients after surgery: A 1-year follow-up study

BackgroundThe relation between serum uric acid and bone metabolism has been reported in many studies, but few studies have focused on serum uric acid and fracture rehabilitation. We aimed to explore the potential relationships between serum uric acid and outcomes of hip fractures. MethodsA total of 742 patients with hip fractures who underwent surgeries between December 2017 and February 2021 and met the inclusion criteria were included. The data of male and female patients were analyzed separately. Cox models with different adjusted forms were performed to explore the potential risk factors, and restricted cubic splines were used to determine the nonlinear relationships between serum uric acid and outcomes and optimal cutoff points of serum uric acid. Then, the outcomes were analyzed in the groups divided by cutoff points mentioned above, as well as groups divided by the diagnosis of hyperuricemia or gout. ResultsCox analysis showed that hyperuricemia or gout was associated with increased death risk, and a typical J-shaped curve was observed in the restricted cubic spline. For male patients, a serum uric acid of high level may relate to a high risk of 6-month (P = .008) and 1-year (P = .016) mortality, and a serum uric acid of low level may predict a poor 6-month free walking ability. For female patients, both a serum uric acid of high level and low level were associated with poor 1-year survival (all P < .05), and a serum uric acid of high level may relate to poor 6-month (P = .001) and 1-year (P = .001) free walking ability. ConclusionPatients with hyperuricemia or gout or patients with high and low levels of serum uric acid may face poor outcomes of hip fractures.

Descriptive case report on the postoperative rehabilitation of roof and posterior column acetabular fracture following accidental event

Descriptive case report on the postoperative rehabilitation of roof and posterior column acetabular fracture following accidental event

Physical rehabilitation for fractures of the lower extremities in mature men

Features of physical rehabilitation at fractures of the lower extremities in men, which are one of the most dangerous and serious traumatic conditions, are considered. The program of physical rehabilitation, which allows the most economical and rational approach to solving the problem of rehabilitation of patients with diaphysis and fragmentary fractures of the tubular bones of the lower extremities. he effectiveness of this program, which included exercise therapy; physiotherapy; massage and hydromassage, gave positive results and the recovery process took less time. The program will help restore walking skills and improve the physical condition of patients through methods, principles, objectives of physical therapy.

Endo-Aesthetic rehabilitation of complicated crown-root fracture of maxillary lateral incisor by fragment reattachment: A case report

In case of traumatic injuries to the anterior teeth, fragment reattachment is considered a minimally invasive technique. Re-attaching the same tooth fragment, possesses the advantage, of biomimicry by complete restoration of form, function, texture, lustre, and translucency. Due to advancements in adhesive dentistry, simple re-attachment to complex fragment rehabilitation have become predictable and reliable. Various techniques have been proposed for fragment reattachment based on the extent of injury, type of injury, condition of the fragment, and time- lapse. This case report demonstrates the endo-aesthetic rehabilitation of a complicated crown root fracture using a fiber post on lateral incisor with fracture line on the cervical 1/3of the labial aspect, running obliquely and apically towards the palatal surface after 1 year follow-up.

Improved activities of daily living in elderly patients with increased skeletal muscle mass during vertebral compression fracture rehabilitation.

We hypothesized that elderly patients with greater skeletal muscle mass have better activities of daily living (ADLs) than those with less skeletal muscle mass. The aim of this study was to evaluate the relationship between ADL improvement and changes in skeletal muscle mass among older patients ≥ 80years of age who were undergoing rehabilitation for vertebral compression fracture (VCF). This case-control study was conducted at a rehabilitation hospital. The participants were 149 patients aged ≥ 80years undergoing VCF rehabilitation. Patients were divided into two groups based on changes in their skeletal muscle mass index (SMI) during the hospitalization period: one group with increased SMI and the other without increased SMI. Between-group and multivariate analyses were performed to evaluate the factors associated with SMI increase. The functional independence measure (FIM) gain was significantly higher in the group with SMI increase (36.0 [27.0-52.5], p = 0.016) than in the group without SMI increase (29.0 [19.0-41.0]). SMI gain was significantly associated with motor FIM gain (coefficient, 4.857; 95% confidence interval, 1.311-8.403; p = 0.008). Motor FIM and MMSE on admission, the necessity of assistance in ADL before the injury, and Charlson Comorbidity Index, were also significantly associated with motor FIM gain. This study indicated that rehabilitation to gain skeletal muscle was effective in improving ADLs in elderly patients with VCF. We might encourage older patients with VCFs to undertake rehabilitation for the purpose of building skeletal muscle and improving their ADLs, and to not refrain from such rehabilitation due to old age and fractures.

Chronic Pain Due to Pelvis Fracture and Perceptive Rehabilitation

Recently, somatosensory rehabilitation is knowing a growing interest in chronic pain condition. In fact, new evidences have associated an impaired lumbopelvic control with a decreased tactile acuity, generating and sustaining chronic low back pain mechanisms. Consequently, an adequate tactile rehabilitation, entailing a discrimination training with a stimulation tasks, seems to be effective on pain, reducing lumbopelvic impairments.&#x0D; Also the use of perceptual surfaces can be effective on back pain, favouring a tactile and proprioceptive sensory stimulation on the trunk and improving the postural control through a body midline realignment.&#x0D; The aim of this manuscript was to describe the preliminary evidences on two cases of chronic pain due to pelvis fracture treated with the perceptive surfaces. Furthermore, we have tried to clarify the mechanisms involved in chronic back pain and the effect of a somatosensory rehabilitation. Finally, it was analyzed the role of craniocaudal body midline with the gravitational vertical axis in the setting of correct alignment for improving postural control in these conditions.

Rehabilitation of a sub-trochanteric fracture of a 43-year-old male with a permanent disability of right lower limb: a case report

Rehabilitation of a sub-trochanteric fracture of a 43-year-old male with a permanent disability of right lower limb: a case report

Effects of Visual Feedback During Balance Training on Knee Function and Balance Ability in Postoperative Patients After Knee Fracture: A Randomized Controlled Trial.

ObjectiveTo investigate the effects of visual feedback training on knee function and balance ability in postoperative patients with knee fracture.MethodsA clinical randomized controlled trial with 104 participants, randomly assigned (1:1) to a visual feedback training group or a control group. Eligible participants were evaluated using Lysholm scores, the Tinetti scale, and the evaluation module of TecnoBody® to demonstrate dynamic balance function in a standing position before treatment and after 4 and 8 weeks of treatment.ResultsBoth visual feedback training and control groups improved significantly in the Lysholm and Tinetti scores after 8 weeks. Compared with the control group, the TecnoBody® tests included centre of pressure path length, and the area over centre of pressure movement, both of which significantly improved in the visual feedback training group at 8 weeks after treatment. There was no difference between the 2 groups in terms of their Lysholm scores and Tinetti gait before the intervention and 4 weeks after treatment.ConclusionApplying visual feedback training in conjunction with traditional rehabilitation strategies may improve knee function and motor control in postoperative patients with knee fracture. Although visual feedback training does not have a short-term effect on knee function and gait, this method could be a useful addition for rehabilitation of knee fracture patients.LAY ABSTRACTThis study used the TecnoBody® (PK-254P, Bergamo, Italy) to evaluate balance in the standing position of all participants. This equipment provides data on the centre of pressure path length and the area over which the centre of pressure moves. The Lysholm score was used to assess knee function, and the Tinetti scale to assess motor control. Applying visual feedback training in conjunction with traditional rehabilitation strategies could decrease postural sway and increase motor control in postoperative patients with knee fracture, as well as subsequently improve knee function and balance ability. There were no adverse effects due to the combined rehabilitation programme.

Pain, hand function, activity performance and apprehensiveness, in patients with surgically treated distal radius fractures

Distal radius fracture (DRF) is a common injury, affecting both function and activity performance. Postoperative rehabilitation is an essential part of the treatment of a surgically treated DRF. The study aims were to assess pain, hand function, activity performance and apprehensiveness and their association, during the first three months after a surgically treated DRF. Eighty-eight patients with a DRF were assessed for pain, hand function, activity performance and apprehensiveness three days and two, six and 12 weeks after surgery. The results indicated that pain, range of motion (ROM), grip strength, apprehensiveness, and activity performance (PRWE) improved significantly between follow-ups (p < .001–.01). Apprehensiveness correlated moderately with activity performance on all visits (0.40–0.47, p < .01), which implies a correlation between the variables, but the regression model showed that the differences in the PRWE at twelve weeks cannot be explained by the differences in apprehensiveness or range of motion at cast removal. At 12 weeks, the study participants had regained almost 70% of their grip strength and 74–96% of the ROM of the uninjured hand. The study shows that, during the study period, the participants improved in both pain, hand function and activity performance, and indicates that a simple question on apprehensiveness in terms of using the injured hand in daily life could be an important factor in distal radius fracture rehabilitation.

Mapping Knowledge Structure and Themes Trends of Post-operative Rehabilitation of Hip Fractures in the Elderly: A Bibliometrics and Visualization Study.

BackgroundHip fractures are a common type of fracture in the elderly and are characterized by many complications and high mortality. Many topics concerning postoperative rehabilitation of hip fracture in elderly people still remain controversial, and the global research trend in this field has not yet been well studied. The aim of the present study was to illustrate the overall knowledge structure, development trends, and research hot spots of postoperative rehabilitation of hip fracture in elderly people.MethodsArticles and reviews regarding postoperative rehabilitation of hip fracture in elderly people from 2001 to 2021 were identified from the Web of Science database. An online bibliometric platform, CiteSpace, and VOSviewer software were used to generate visualization knowledge maps, including annual trends of publications, contributions of countries, institutions, authors, funding agencies, and journals, and clustering of keywords.ResultsA total of 1,724 publications were identified from Web of Science Core Collection (WoSCC). In the past 20 years, the number of published studies on the rehabilitation of hip fracture in the elderly has exhibited an overall upward trend. The USA was the leading contributor in this field, with the largest number of publications (354, 20.65%) and the most citations (13,786 times). The international cooperation map among relevant countries/regions indicated that the USA collaborated most closely with Canada and China. The University of Maryland and Professor Marcantonio were the most prolific institution and influential author, respectively. Injury: International Journal of the Care of the Injured was the most productive journal concerning the research of postoperative rehabilitation of hip fracture in elderly people. The keyword co-occurrence analysis identified six clusters: quality of life study, rehabilitation and outcomes study, cognitive impairment study, operative approaches study, mortality study, and osteoporosis study.ConclusionsThere will be an increasing number of publications on the research of postoperative rehabilitation of hip fracture in elderly people, and the United States will stay ahead in this field. Our findings could offer practical sources for scholars to understand the current status and trend of studies on rehabilitation of hip fracture in the elderly and provide references and suggestions for the development of related research in future.

Progressive Resistance Training Program Characteristics in Rehabilitation Programs Following Hip Fracture: A Meta-Analysis and Meta-Regression.

Introduction: Older adults often experience incomplete recovery after a hip fracture. Rehabilitation programs with progressive resistance training are associated with improved functional recovery. This systematic review and meta-analysis with meta-regression a) evaluated resistance training characteristics reported in hip fracture rehabilitation programs, b) performed meta-analysis of resistance training impact on strength (primary outcome), gait and physical activity (secondary outcomes), and c) explored resistance training program characteristics associated with improved outcomes using meta-regression. Materials and Methods: Medline, EMBASE, CINAHLPLUS, and Web of Science Core Collection databases were searched (January2000–February2021). Randomized controlled trials including progressive resistance training rehabilitation programs after hip fracture surgery in adults ≥50 years old were included. Meta-analyses and exploratory meta-regression were performed. Results: Meta-analysis showed significant increases in strength (10 trials-728 participants; Standardized Mean Difference (SMD) [95%CI]; .40 [.02, .78]) immediately following program completion in intervention relative to control participants. Meta-analysis on 5 trials (n = 384) with extended follow up found no significant group differences (SMD = .47 [-.28, 1.23]) in strength. Center-based relative to home-based programs were associated with significantly greater improvements in strength (P < .05) as were programs where resistance training intensity was prescribed using one-repetition maximum relative to other exercise prescription methods (P < .05). In gait meta-analysis (n = 10 trials-704 participants), gait speed in intervention participants immediately after the program was significantly higher than control (SMD = .42 [.08, .76]) but this finding was not maintained in extended follow-up (n = 5 trials-240 participants; SMD = .6 [-.26, .38]). Higher resistance training intensity was associated with significant improvements in gait speed (P < .05). No meta-analysis was performed for the 3 heterogeneous studies reporting physical activity. Discussion: Progressive resistance training improved muscle strength and gait speed after hip fracture surgery in adults ≥50years old immediately after the program ended, but the longer-term impact may be more limited. Conclusions: Higher resistance training intensity and center-based programs may be associated with more improvement, but require further research.

The effectiveness of a physiatrist-led acute hospital based postoperative hip fracture inpatient rehabilitation program: A single-center retrospective study

Background Postoperative hip fracture rehabilitation in Singapore has historically been carried out in both acute and community hospitals (CH). An increasing majority of patients with hip fractures now receive inpatient rehabilitation in CH, and it is often believed that Acute hospital (AH) - based rehabilitation may be less cost-effective than their CH counterparts. Objective: This retrospective study aims to review the effectiveness of an AH-based hip fracture postoperative rehabilitation program. Methods This study retrospectively reviewed the database of postoperative hip fracture patients who underwent a physiatrist-led AH-based inpatient rehabilitation from Jan 2010 to Dec 2016. The primary outcomes were the functional improvement assessed by functional independence measure (FIM) and FIM efficiency. The secondary outcome included the length of stay (LOS), successful discharge to home rate, mortality rate, and complication rate. Results A total of 293 cases were included in the study. After participation in the inpatient rehabilitation program, the mean total FIM increased from 83.9 ± 12.7 (mean ± SD) to 93.9 ± 16.2 ( p &lt; .001). The motor FIM increased from 47.1 ± 10.9 to 56.1 ± 10.1 ( p &lt; .001). 269 (91.8%) patients were successfully discharged home. Inpatient mortality was 0.3% (1/293). The complications rate during inpatient rehabilitation was 16.0% with urinary tract infection being the most frequent complication (10.2%). The median LOS for inpatient rehabilitation was 19 days (15, 28). Conclusions After completing a physiatrist-led postoperative hip fracture inpatient rehabilitation program in an acute hospital, patients demonstrated significant functional improvement ( p &lt; .0001). The inpatient rehabilitation program has a high discharge home rate and low in-hospital mortality.

HIP Fracture REhabilitation Program for older adults with hip fracture (HIP-REP) based on activity of daily living: a feasibility study

BackgroundA Rehabilitation Program for older adults with hip fracture (HIP-REP) based on Activity of Daily Living has been developed. The objectives of this study were to assess the feasibility and safety of the HIP-REP program to inform a future randomized controlled trial (RCT).MethodsA feasibility study Inspired by the Complex-intervention development (Medical Research Council framework phase II) design using quantitative and qualitative research methods were conducted. Eighteen participants (above 65 years) with hip fracture were recruited from the orthopedic wards. The setting was cross sectoral including Copenhagen University Hospital, Herlev and Gentofte and rehabilitation centers in Herlev, Gentofte and Lyngby-Taarbæk municipalities. A cross-sectoral rehabilitation intervention tailored to the needs of older adults with hip fracture highlighting systematic goal setting and strategies focused on activities of daily living was conducted. Pre-defined feasibility criteria: participants recruitment and retention, duration of measuring the outcome, adherence to intervention, and adverse events, along with self-reported outcomes and an objective measurement of performance in activity of daily living. Focus groups were analyzed using a deductive manifest content analysis approach. Descriptive statistical analysis and paired t-tests were performed for assessing change in outcome measures.ResultsRecruitment rate was 4.5/month. Outcome measures were performed but length and number of questionnaires were a burden. Thirteen out of eighteen participants completed the study three dropped out and two died. Adherence among the 13 was 100%. Focus group revealed issues regarding coordinating the intervention, ensuring procedural processes across sectors regarding recruitment of participants, and documentation in the database. Participants expressed satisfaction with the intervention and felt safe during intervention. Assessment of Motor and Process Skills showed better increase between (range 0.4 to 1.6) in ADL motor ability measures and better increase between (range 0.4 to 0.7) for process ability. No clear association between outcome improvements and intervention adherence.ConclusionsThe cross-sectoral intervention based on daily activities was feasible and safe for older adults with hip fracture. A future RCT, with an improved recruitment strategy and reduced number of outcome measures will evaluate the effectiveness in improving independence and safety performance of activity of daily living.Trial registrationClinicalTrials.gov ID: NCT03828240. Registered on January 29, 2019.

Mid-shaft clavicle fractures-factors influencing the clinical outcome after plate osteosynthesis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Clavicle fractures constitute 5-10% of all fractures with. These fracture result from accidental fall, sports injuries or road traffic accidents The location and fracture pattern are important as it decides treatment and outcome. Our study is aimed to assess the various factors like: fracture pattern, type of implant used, and plate positioning and assessing their influence on clinical outcome.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; It was a prospective case-study. The study was done in department of orthopaedics, Government Villupuram Medical College Hospital Villupuram between December 2017 and December 2019. Those patients in whom there was indication for surgical management, and who were willing for surgery were admitted. Plate osteosynthesis was done using anatomical locking plate, recon plate, tubular plate. Post operative rehabilitation done. Functional and radiological assessment done at regular interval till fracture union.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; All 32 patients had good union. Mean interval for fracture union was 4 months. 2 cases had implant failure, for which implant exit was done without any complication.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Anatomical locking plate prove to be the ideal implant for management of mid shaft clavicle fracture. Failure by mechanical mode can be prevented by using lag screws and avoiding fracture spanning. Biological mode of failure can be prevented by guarded post operative rehabilitation in comminuted fractures.&lt;/p&gt;

Evidence-based intervention on postoperative fear, compliance, and self-efficacy in elderly patients with hip fracture.

BACKGROUNDElderly patients tend to have poor self-efficacy and poor confidence in postoperative rehabilitation for hip fractures, and are prone to negative emotions, which affect treatment compliance.AIMTo evaluate the effects of evidence-based intervention on postoperative fear, compliance, and self-efficacy in elderly patients with hip fractures.METHODSA total of 120 patients with hip fracture surgically treated from June 2018 to June 2020 at the orthopedic department of our hospital were selected and divided into intervention and routine groups (n = 60 each) according to different nursing methods. The basic rehabilitation methods of the two groups were consistent, but patients in the intervention group received evidence-based nursing interventions at the same time. Differences between groups in the scores of motion phobia, pain fear, rehabilitation training compliance, self-efficacy, nursing satisfaction, and hip joint function were compared before and after the intervention. RESULTSBefore the intervention, there were no statistically significant differences in motion phobia and pain fear scores between the groups (all P > 0.05). However, motion phobia scores at 1 wk after intervention initiation (P < 0.05), and pain fear scores at 1 wk and 2 wk after intervention initiation (all P < 0.05), were significantly lower in the intervention group than in the routine group. On the first day of intervention, there was no significant difference in rehabilitation treatment compliance between the groups (P > 0.05); however, at 2 wk after intervention initiation, rehabilitation compliance was significantly better in the intervention group than in the routine group (P < 0.05). Before the intervention, there were no statistically significant differences in the scores for the two self-efficacy dimensions (overcoming difficulties and rehabilitation exercise self-efficacy) and the total self-efficacy score between the groups (all P > 0.05). After 2 wk of intervention, the scores for these two dimensions of self-efficacy and the total self-efficacy score were significantly higher in the intervention group than in the routine group (all P < 0.05). At 3 and 6 mo after surgery, hip function as evaluated by the Harris hip score, was significantly better in the intervention group than in the routine group (P < 0.05). Additionally, overall nursing satisfaction was significantly higher in the intervention group than in the routine group (P < 0.05). CONCLUSIONEvidence-based nursing intervention can alleviate fear of postoperative rehabilitation in elderly patients who underwent hip fracture surgery, and improve rehabilitation treatment compliance and patient self-efficacy, which promote hip function recovery.