PHYSIOTHERAPY MANAGEMENT OF PATIENTS WITH PELVIC FRACTURES IN SELECTED PHYSIOTHERAPY CLINICAL TRAINING SITES, SOUTH AFRICA

N. Sobantu¹, L. Kirimi¹, T. Masera¹, O. Shilala¹, E. Tema¹, M. Tshivhase¹

¹Sefako Makgatho Health Sciences University, Physiotherapy, Pretoria, South Africa

Background: Pelvic fractures lead to disability and poor Health Related Quality of Life and thus contributing to the burden of disease in South Africa. Due to the complexity of pelvic fractures, there is a need for early involvement of the multidisciplinary team. Amongst the team, physiotherapists play a role in improving the Health Related Quality of Life of patients with pelvic fractures. Physiotherapists provide treatment and rehabilitation for patients with pelvic fractures to restore the patient’s function, improve mobility, relieve pain, and prevent or decrease permanent physical disabilities.

Purpose: The purpose of this study was to determine the physiotherapy management of patients with pelvic fractures in selected clinical training sites in South Africa.

Methods: Adescriptive cross-sectional study survey was conducted using a questionnaire that was adapted from two validated and reliable questionnaires. A convenience sampling method was used to identify 30 physiotherapists employed in the selected clinical training sites. All participants signed an informed consent before participating in the study. Anonymity was maintained by ensuring that the names of participants did not appear in the questionnaires. Ethical clearance was obtained from the university's ethics committee for human subjects before data collection.

Results: The majority of participants were between 25-29 years with a mean age of 29.80±8.62 years. Eighty percent (80%) of participants were females. The clinical experience of 14(47%) participants ranged from 2-10 years, of 13(43%) was ≤1 year and three (10%) had more than 10 years’ experience. Ten percent of the participants were community service physiotherapists. Exercises used the most were quadriceps exercises followed by foot pumps, gait training with crutches, bridging, heel slides, active toes movements and gluteus sets in the management of patients with pelvic fractures. Most modalities used were soft tissue mobilisation, myofascial release and trigger point therapy. The most commonly used outcome measurement tools out of the ten indicated in the questionnaire were Berg Balance Scale, six-minute walk test and time up and go test.

Conclusions: Pelvic floor exercises were used less. Pain management was not prioritized which could have compromised the effectiveness of the rehabilitation. Functional outcome measurement tools were seldom used to assess the effectiveness of the treatment and patient outcomes, especially in preparation for discharge of patients.

Implications: To improve quality of care in patients
To contribute to continued professional development of physiotherapists
Add value to student learning about management of patients with pelvic fractures

Funding acknowledgements: The study was not funded.

Keywords:
Pelvic fractures
Physiotherapy management
Outcome measurement tools

Topics:
Disability & rehabilitation
Education: continuing professional development
Musculoskeletal: lower limb

Did this work require ethics approval? Yes

Institution: Sefako Makgatho Health Sciences University

Committee: Sefako Makgatho Health Sciences Research and Ethics committee

Ethics number: SMUREC/H/215/2019: UG