Article

Lower-extremity injuries constitute the leading cause of trauma
hospitalizations among people under the age of 65 years. Rehabilitation has the
potential to favorably influence the outcomes associated with traumatic
lower-extremity injuries. OBJECTIVES: The objectives of this study were to
explore variability in surgeon and physical therapist assessments of the need for
physical therapy in patients with traumatic lower-extremity injuries and to
determine the factors associated with assessments of need. DESIGN: This study was
a retrospective cohort investigation. METHODS: Participants were 395 patients
treated by reconstruction in the Lower-Extremity Assessment Project. They were
evaluated at 8 level I trauma centers at 3, 6, and 12 months after
hospitalization by an orthopedic surgeon and a physical therapist to determine
the need for physical therapy. Analyses included multilevel logistic regression.
RESULTS: Chi-square analyses showed that surgeon and therapist assessments of
need differed statistically across trauma centers. Surgeons were more likely to
assess a need for therapy at 3 months when participants had low work
self-efficacy, impaired knee flexion range of motion (ROM), and weight-bearing
limitations and at 6 and 12 months when participants had impaired knee flexion
ROM and weight-bearing and balance limitations. Therapists were more likely to
assess a need for therapy at 3 months when participants had moderate to severe
pain and at 6 and 12 months when participants had low work self-efficacy, pain,
impaired knee flexion ROM, and balance limitations. CONCLUSIONS: The results
revealed variability in assessments of the need for physical therapy at the
provider and trauma center levels. Differences in provider assessments highlight
the need for communication and further investigation into the outcomes and timing
of physical therapy for the treatment of traumatic lower-extremity injuries.

Langue : ANGLAIS