Postoperative rehabilitation training adherence and influencing factors in adults with traumatic fractures in China: a cross-sectional study

Abstract

Objective: To explore rehabilitation training adherence as well as its related influencing factors among adult patients with traumatic limb fractures to provide a basis for clinical intervention strategies.

Design: Cross-sectional study.

Setting: Department of Rehabilitation Medicine.

Participants: Adults within 1 year postoperative for traumatic limb fractures and who underwent rehabilitation training were included in this study.

Interventions: Not applicable.

Main outcome measures: Patient information was collected using a self-designed general information form. Rehabilitation training adherence was evaluated using the Exercise Adherence Rating Scale (0/64, higher values=higher adherence). Barriers to and facilitators of rehabilitation were assessed using sociodemographic data, ability to perform daily life (ADL), General Self-Efficacy Scale (GSES) and Visual Analogue Scale. Pearson's (r) and determination (R²) correlation coefficients were calculated to determine the strength of associations between variables. Potential correlates were explored using multiple linear regression analysis.

Results: Between December 2022 and December 2023, 180 subjects were recruited. The age of the participants ranged from 18 to 93 years, with a mean age of 41.5 years (SD 15.6). The mean Exercise Adherence score was 30.31 (SD 5.8). Adherence to postoperative rehabilitation training tended to be lower in participants of older age (-1.30; 95% CI -2.14 to -0.46; p=0.003), and those who had higher pain scores on the movement (moderate pain (-3.25; 95% CI -4.56 to -1.95; p<0.001) to severe pain (-5.42; 95% CI -7.31 to -3.54; p<0.001)), less education (-2.90; 95% CI -4.17 to -1.64; p<0.001), fewer family income (-1.82; 95% CI -2.77 to -0.87; p<0.001), treated at home (-1.90; 95% CI -3.35 to -0.45; p=0.011) and with lower GSES scores (0.25; 95% CI 0.16 to 0.34; p<0.001).

Conclusions: Patients with limb fractures require rehabilitation but often struggle with adherence to interventions. Strategies that focus on targeted education programmes, pain management and self-efficacy improvement may be considered to guide future research and programmatic approaches to enhance adherence to rehabilitation training.

Keywords: Cross-Sectional Studies; Fractures, Bone; Pain management; REHABILITATION MEDICINE.

Figure 1. The flow diagram.