A cross-sectional study of the impact of physiotherapy and self directed exercise on the functional outcome of internally fixed isolated unimalleolar Weber B ankle fractures

作者：Karam E; Shivji F S; Bhattacharya A; Bryson D J; Forward D P; Scammell B E^*; Ollivere B J

来源：Injury-International Journal of the Care of the Injured, 2017, 48(2): 531-535.

DOI：10.1016/j.injury.2016.11.009

• Ankle fracture
• Function
• Outcome
• Exercise
• Physiotherapy

This study aimed to measure the functional outcome and quality of life in a group of patients with the same fracture type (unimalleolar Weber B ankle fractures) treated operatively at various time points and to explore the determinants of such outcomes. A cross-sectional retrospective population study was conducted. Validated Patient Related Outcome Measures (PROMs) and patient interviews were used. Fifty-one patients were included with a mean age of 54.9 years. Mean follow-up was 25 months (range 446 months). Mean functional scores were high (mean AOFAS 79.2, O& M 75.7, VAS-FA 80.5). However, 32% of patients did not classify themselves as fully recovered during interviews. Patient reported self-directed exercise had a statistically significant positive effect on self-reported patient perceptions of outcome (p = 0.022) and PROMs (AOFAS p = 0.01, O & M p = 0.016, VAS-FA p =0.011). Formal physiotherapy rehabilitation was found to have no effect on self-reported patient perceptions (p=0.242) or PROMs (AOFAS p = 0.8, O& M p = 0.73, VAS-FA p = 0.46). Our finding that physical activity is associated with improved outcome would suggest structured exercise programmes should be considered in place of physiotherapy to optimise patient outcomes.

• 出版日期2017-2