PMID- 30042629
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 1066-9817 (Print)
IS  - 2042-6186 (Electronic)
IS  - 1066-9817 (Linking)
VI  - 26
IP  - 3
DP  - 2018 Jul
TI  - Timing of initiating manual therapy and therapeutic exercises in the management 
      of patients after hindfoot fractures: a randomized controlled trial.
PG  - 147-156
LID - 10.1080/10669817.2018.1432542 [doi]
AB  - STUDY DESIGN: Randomized clinical trial. BACKGROUND: Patients with fractures to 
      the talus and calcaneus report decreased functional outcomes and develop 
      long-term functional limitations. Although physical therapy is typically not 
      initiated until six weeks after fixation, there's little research on the optimal 
      time to initiate a formal physical therapy program. OBJECTIVES: To assess whether 
      initiating physical therapy including range of motion (ROM) and manual therapy 
      two weeks post-operatively (EARLY) vs. six weeks post-operatively (LATE) in 
      patients with fixation for hindfoot fractures results in different clinical 
      outcomes. METHODS: Fifty consecutive participants undergoing operative fixation 
      of a hindfoot fracture were randomized to either EARLY or LATE physical therapy. 
      Outcomes, including the American Orthopedic Foot and Ankle Society Hindfoot Scale 
      (AOFAS), the Lower Extremity Functional Scale (LEFS), active ROM, swelling, and 
      pain, were collected at three and six months and analyzed using linear 
      mixed-modeling to examine change over time. Adverse events were tracked for 
      12 months after surgery. RESULTS: The EARLY group demonstrated significantly 
      larger improvements for the AOFAS (p = .01) and the LEFS (p = .01) compared to 
      the LATE group. Pairwise comparison of the LEFS favors the EARLY group at 
      6 months [7.5 (95%CI -.01 to 15.0), p = .05]. There were no differences between 
      the groups with regard to ROM, pain, and swelling. The LATE group incurred 
      increased adverse events in this study. CONCLUSION: Initiating early physical 
      therapy may improve long-term outcomes and mitigate complications in patients 
      after hindfoot fractures. LEVEL OF EVIDENCE: Therapy, level 2b.
FAU - Albin, Stephanie R
AU  - Albin SR
AD  - School of Physical Therapy, Regis University, Denver, CO, USA.
AD  - Intermountain Healthcare, Salt Lake City, UT, USA.
FAU - Koppenhaver, Shane L
AU  - Koppenhaver SL
AD  - Department of Physical Therapy, Baylor University, Dallas, TX, USA.
FAU - Van Boerum, Drew H
AU  - Van Boerum DH
AD  - Department of Orthopedics, The Orthopedic Specialty Hospital, Salt Lake City, UT, 
      USA.
FAU - McPoil, Thomas G
AU  - McPoil TG
AD  - School of Physical Therapy, Regis University, Denver, CO, USA.
FAU - Morgan, James
AU  - Morgan J
AD  - Department of Orthopedics, The Orthopedic Specialty Hospital, Salt Lake City, UT, 
      USA.
FAU - Fritz, Julie M
AU  - Fritz JM
AD  - Department of Physical Therapy, College of Health, University of Utah, Salt Lake 
      City, UT, USA.
LA  - eng
PT  - Journal Article
DEP - 20180212
PL  - England
TA  - J Man Manip Ther
JT  - The Journal of manual & manipulative therapy
JID - 9433812
PMC - PMC6055963
OTO - NOTNLM
OT  - Calcaneus Fracture
OT  - outcomes
OT  - rehabilitation
OT  - talus fracture
EDAT- 2018/07/26 06:00
MHDA- 2018/07/26 06:01
PMCR- 2019/07/01
CRDT- 2018/07/26 06:00
PHST- 2018/07/26 06:00 [entrez]
PHST- 2018/07/26 06:00 [pubmed]
PHST- 2018/07/26 06:01 [medline]
PHST- 2019/07/01 00:00 [pmc-release]
AID - yjmt-26-147 [pii]
AID - 10.1080/10669817.2018.1432542 [doi]
PST - ppublish
SO  - J Man Manip Ther. 2018 Jul;26(3):147-156. doi: 10.1080/10669817.2018.1432542. 
      Epub 2018 Feb 12.