title: 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.
abstract: 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 4-46 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.
authors.affiliation: University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: E
authors.initials: E
authors.lastname: Karam
authors.affiliation: University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: F S
authors.initials: FS
authors.lastname: Shivji
authors.affiliation: University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Bhattacharya
authors.affiliation: University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Bryson
authors.affiliation: University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: D P
authors.initials: DP
authors.lastname: Forward
authors.affiliation: University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK. Electronic address: b.scammell@nottingham.ac.uk.
authors.forename: B E
authors.initials: BE
authors.lastname: Scammell
authors.affiliation: University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: B J
authors.initials: BJ
authors.lastname: Ollivere
mesh_terms: D000328:Adult; D064386:Ankle Fractures / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D000843:Ankle Joint / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011788:Quality of Life; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Ankle fracture; Exercise; Function; Outcome; Physiotherapy