title: Dysfunction and post-traumatic stress disorder in fracture victims 50 months after the Sichuan earthquake.
abstract: BACKGROUND
  This study aimed to evaluate the effectiveness of a rehabilitation intervention on physical dysfunction (PDF) and post-traumatic stress disorder (PTSD) in fracture victims 50 months after the Sichuan earthquake of 2008 and to identify risk factors for PTSD.
  
  
  METHODS
  This is a retrospective cohort study. Four hundred and fifty-nine earthquake-related fracture victims from Mianzhu city, Sichuan Province who did not qualify for disability pension participated. Two hundred and forty-five subjects received regular rehabilitation and 214 did not. Muscle strength, joint range of motion (ROM),sensory function, and sit-to-stand balance capacity were evaluated to assess PDF. The PTSD Checklist-Civilian Version (PCL-C) was administered to screen for PTSD. An ordinary least square regression was used to predict PTSD, and a logistic regression was used to predict PDF. In addition a Least Angle Regression (LARS) was carried out for PTSD to study the effects of rehabilitation and PDF at the same time.
  
  
  RESULTS
  Unadjusted and adjusted group differences in physical dysfunction (p<0.01) and PTSD prevalence (p<0.05) were significant in favor of the rehabilitation group. In addition, being female, average or above family income, having witnessed death and fearfulness were found risk factors for PTSD symptoms 50 months after the earthquake. Both PDF and rehabilitation were selected predictors by LARS demonstrating opposite effects.
  
  
  CONCLUSIONS
  PDF and PTSD were significantly reduced by the rehabilitation intervention. Future medical intervention strategies should consider rehabilitation in order to assist survivors in dealing with both physical and psychological effects of natural disaster.
authors.affiliation: Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China ; Department of Rehabilitation Medicine, The Affiliated Hospital of Nantong University, Nantong, China ; Caring For Children Foundation, Hong Kong, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ni
authors.forename: Jan D
authors.initials: JD
authors.lastname: Reinhardt
authors.forename: Xia
authors.initials: X
authors.lastname: Zhang
authors.forename: Mingyue
authors.initials: M
authors.lastname: Xiao
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.forename: Hong
authors.initials: H
authors.lastname: Jin
authors.forename: Xianmin
authors.initials: X
authors.lastname: Zeng
authors.forename: Jianan
authors.initials: J
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003430:Cross-Sectional Studies; D004190:Disasters; D055866:Earthquakes; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation*; D017741:Survivors / Q000523:psychology; D055815:Young Adult