Task-oriented exercises improve disability of working patients with surgically-treated proximal humeral fractures. A randomized controlled trial with one-year follow-up
Abstract Background General physiotherapy is a common means of rehabilitation after surgery for proximal humeral fracture (PHF). Better-targeted exercises seem worthy of investigation and the aim of this study was to assess the efficacy of a rehabilitation program including task-oriented exercises i...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-03-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-021-04140-9 |
| _version_ | 1818649073559797760 |
|---|---|
| author | Marco Monticone Igor Portoghese Daniele Cazzaniga Valentina Liquori Giuseppe Marongiu Antonio Capone Marcello Campagna Giovanni Zatti |
| author_facet | Marco Monticone Igor Portoghese Daniele Cazzaniga Valentina Liquori Giuseppe Marongiu Antonio Capone Marcello Campagna Giovanni Zatti |
| author_sort | Marco Monticone |
| collection | DOAJ |
| description | Abstract Background General physiotherapy is a common means of rehabilitation after surgery for proximal humeral fracture (PHF). Better-targeted exercises seem worthy of investigation and the aim of this study was to assess the efficacy of a rehabilitation program including task-oriented exercises in improving disability, pain, and quality of life in patients after a PHF. Methods By means of a randomized controlled trial with one-year follow-up, 70 working patients (mean age of 49 ± 11 years; 41 females), who were selected for open reduction and internal fixation with plates caused by PHF, were randomized to be included in an experimental (n = 35) or control group (n = 35). There was a permuted-block randomization plan, and a list of program codes was previously created; subsequently, an automatic assignment system was used to conceal the allocation. The first group underwent a supervised rehabilitation program of task-oriented exercises based on patients’ specific job activities, and occupational therapy. The second group underwent general physiotherapy, including supervised mobility, strengthening and stretching exercises. Both groups individually followed programs of 60-min session three times per week for 12 weeks in the outpatient setting. The Disability Arm Shoulder Hand questionnaire (DASH; scores range from 0 to 100; primary outcome), a Pain intensity Numerical Rating Scale (scores range 0 to 10; secondary outcomes), and the Short-Form Health Survey (scores range from 0 to 100; secondary outcomes) assessed the interventions. Participants were evaluated before surgery, before and after rehabilitation (primary endpoint), and at the one-year follow-up (secondary endpoint). A linear mixed model analysis for repeated measures was carried out for each outcome measure (p < 0.05). Results Time, group and time by group showed significant effects for all outcome measures in favour of the experimental group. The DASH and the DASH work achieved clinically important between-group differences of 16.0 points (95% confidence interval [C.I.] 7.3 to 24.7) and 19.7 (95% C.I. 9.0 to 30.5) at follow-up, respectively. The NRS achieved a between-group difference of 2.9 (95% C.I. 1.0 to 3.9) at follow-up. As for SF-36, there were between-group differences ranging from 17.9 to 37.0 at follow-up. Conclusions A rehabilitation program based on task-oriented exercises was useful in improving disability, pain, and quality of life in working patients after PHFs. Improvements lasted for at least 12 months. Trial registration On 16/12/2019, the trial was retrospectively registered in the ISRCTN registry with the ID number 17996552 . |
| first_indexed | 2024-12-17T01:28:31Z |
| format | Article |
| id | doaj.art-346d598c89b34d758bb82d9b90930e52 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-17T01:28:31Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-346d598c89b34d758bb82d9b90930e522022-12-21T22:08:39ZengBMCBMC Musculoskeletal Disorders1471-24742021-03-0122111110.1186/s12891-021-04140-9Task-oriented exercises improve disability of working patients with surgically-treated proximal humeral fractures. A randomized controlled trial with one-year follow-upMarco Monticone0Igor Portoghese1Daniele Cazzaniga2Valentina Liquori3Giuseppe Marongiu4Antonio Capone5Marcello Campagna6Giovanni Zatti7Department Medical Sciences and Public Health, University of CagliariDepartment Medical Sciences and Public Health, University of CagliariIstituti Clinici Scientifici Maugeri IRCCSIstituti Clinici Scientifici Maugeri IRCCSOrthopaedic and Trauma Clinic, Department of Surgical Sciences, University of CagliariOrthopaedic and Trauma Clinic, Department of Surgical Sciences, University of CagliariDepartment Medical Sciences and Public Health, University of CagliariBicocca University of MilanAbstract Background General physiotherapy is a common means of rehabilitation after surgery for proximal humeral fracture (PHF). Better-targeted exercises seem worthy of investigation and the aim of this study was to assess the efficacy of a rehabilitation program including task-oriented exercises in improving disability, pain, and quality of life in patients after a PHF. Methods By means of a randomized controlled trial with one-year follow-up, 70 working patients (mean age of 49 ± 11 years; 41 females), who were selected for open reduction and internal fixation with plates caused by PHF, were randomized to be included in an experimental (n = 35) or control group (n = 35). There was a permuted-block randomization plan, and a list of program codes was previously created; subsequently, an automatic assignment system was used to conceal the allocation. The first group underwent a supervised rehabilitation program of task-oriented exercises based on patients’ specific job activities, and occupational therapy. The second group underwent general physiotherapy, including supervised mobility, strengthening and stretching exercises. Both groups individually followed programs of 60-min session three times per week for 12 weeks in the outpatient setting. The Disability Arm Shoulder Hand questionnaire (DASH; scores range from 0 to 100; primary outcome), a Pain intensity Numerical Rating Scale (scores range 0 to 10; secondary outcomes), and the Short-Form Health Survey (scores range from 0 to 100; secondary outcomes) assessed the interventions. Participants were evaluated before surgery, before and after rehabilitation (primary endpoint), and at the one-year follow-up (secondary endpoint). A linear mixed model analysis for repeated measures was carried out for each outcome measure (p < 0.05). Results Time, group and time by group showed significant effects for all outcome measures in favour of the experimental group. The DASH and the DASH work achieved clinically important between-group differences of 16.0 points (95% confidence interval [C.I.] 7.3 to 24.7) and 19.7 (95% C.I. 9.0 to 30.5) at follow-up, respectively. The NRS achieved a between-group difference of 2.9 (95% C.I. 1.0 to 3.9) at follow-up. As for SF-36, there were between-group differences ranging from 17.9 to 37.0 at follow-up. Conclusions A rehabilitation program based on task-oriented exercises was useful in improving disability, pain, and quality of life in working patients after PHFs. Improvements lasted for at least 12 months. Trial registration On 16/12/2019, the trial was retrospectively registered in the ISRCTN registry with the ID number 17996552 .https://doi.org/10.1186/s12891-021-04140-9Proximal humeral fracturesSurgeryRehabilitationTask-oriented exercises |
| spellingShingle | Marco Monticone Igor Portoghese Daniele Cazzaniga Valentina Liquori Giuseppe Marongiu Antonio Capone Marcello Campagna Giovanni Zatti Task-oriented exercises improve disability of working patients with surgically-treated proximal humeral fractures. A randomized controlled trial with one-year follow-up BMC Musculoskeletal Disorders Proximal humeral fractures Surgery Rehabilitation Task-oriented exercises |
| title | Task-oriented exercises improve disability of working patients with surgically-treated proximal humeral fractures. A randomized controlled trial with one-year follow-up |
| title_full | Task-oriented exercises improve disability of working patients with surgically-treated proximal humeral fractures. A randomized controlled trial with one-year follow-up |
| title_fullStr | Task-oriented exercises improve disability of working patients with surgically-treated proximal humeral fractures. A randomized controlled trial with one-year follow-up |
| title_full_unstemmed | Task-oriented exercises improve disability of working patients with surgically-treated proximal humeral fractures. A randomized controlled trial with one-year follow-up |
| title_short | Task-oriented exercises improve disability of working patients with surgically-treated proximal humeral fractures. A randomized controlled trial with one-year follow-up |
| title_sort | task oriented exercises improve disability of working patients with surgically treated proximal humeral fractures a randomized controlled trial with one year follow up |
| topic | Proximal humeral fractures Surgery Rehabilitation Task-oriented exercises |
| url | https://doi.org/10.1186/s12891-021-04140-9 |
| work_keys_str_mv | AT marcomonticone taskorientedexercisesimprovedisabilityofworkingpatientswithsurgicallytreatedproximalhumeralfracturesarandomizedcontrolledtrialwithoneyearfollowup AT igorportoghese taskorientedexercisesimprovedisabilityofworkingpatientswithsurgicallytreatedproximalhumeralfracturesarandomizedcontrolledtrialwithoneyearfollowup AT danielecazzaniga taskorientedexercisesimprovedisabilityofworkingpatientswithsurgicallytreatedproximalhumeralfracturesarandomizedcontrolledtrialwithoneyearfollowup AT valentinaliquori taskorientedexercisesimprovedisabilityofworkingpatientswithsurgicallytreatedproximalhumeralfracturesarandomizedcontrolledtrialwithoneyearfollowup AT giuseppemarongiu taskorientedexercisesimprovedisabilityofworkingpatientswithsurgicallytreatedproximalhumeralfracturesarandomizedcontrolledtrialwithoneyearfollowup AT antoniocapone taskorientedexercisesimprovedisabilityofworkingpatientswithsurgicallytreatedproximalhumeralfracturesarandomizedcontrolledtrialwithoneyearfollowup AT marcellocampagna taskorientedexercisesimprovedisabilityofworkingpatientswithsurgicallytreatedproximalhumeralfracturesarandomizedcontrolledtrialwithoneyearfollowup AT giovannizatti taskorientedexercisesimprovedisabilityofworkingpatientswithsurgicallytreatedproximalhumeralfracturesarandomizedcontrolledtrialwithoneyearfollowup |