Title : Rehabilitation following proximal humeral fracture in the UK National Health Service : A survey of publicly facing information .
Pauline May
Introduction : Proximal humeral fractures ( PHF ) are a common injury in the older population but there is limited research evaluating rehabilitation following PHF . The aim of this study was to understand current National Health Service ( NHS ) practice for rehabilitation following PHF as a platform for conducting future research .
Methods : Two reviewers independently undertook electronic searches for publicly available information sheets ( PIS ) from websites of NHS Trusts that included detail about rehabilitation following PHF , for example , duration of immobilisation . One reviewer extracted data and a second reviewer verified this .
Results : Seventeen PIS from 17 different NHS trusts were identified . All provided some information on the method of immobilisation but only six provided guidance on duration of immobilisation with the median time being 2 weeks ( range 0 – 6 ). The median time to commencement of passive exercise was 2 weeks ( range 0 – 4 ) and 9 weeks ( range 6 – 12 ) for active exercise . Only one PIS reported on the time for commencement of resisted exercises and this was reported as 6 weeks . The median time recommended return to work was 7.5 weeks ( range 6 – 12 ).
Conclusion : This study found limited publicly available information for rehabilitation following PHF in the NHS but offers some insight into current approaches . Our results will facilitate development of relevant information for patients and evaluation of rehabilitation strategies in future research .
Impact : This study has informed understanding of rehabilitation following PHF and highlighted the limited and variable information available to patients . Variability of information and approaches to rehabilitation risks not achieving optimal clinical outcomes . As PHF is common and burdensome , there is a need for high-quality research to inform optimal rehabilitation approaches .
References :
Handoll , H . H . G ., & Brorson , S . ( 2015 ). Interventions for treating proximal humeral fractures in adults . Cochrane Database of Systematic Reviews , 11 , CD000434 . https :// doi . org / 10.1002 / 14651858 . CD000434 . pub4