Rehabilitation After Lower Extremity Nailing Trial

Rehabilitation After Lower Extremity Nailing Trial

The goal of this clinical trial is to learn if outpatient physical therapy (PT) results in differing functional outcomes compared to a self-guided home exercise program (HEP) in tibial or femoral nail patients. The hypothesis is that outpatient PT does not result in superior functional outcomes when compared to a self-guided home exercise program. Outpatient physical therapy for mobility and gait training is the current standard of care following lower extremity fractures.

To test this question, patients will be randomized into either PT or HEP group with PT serving as the control. Researchers will compare the PT and HEP groups to see if patient outcomes differ.

People who agree to join the study will be asked to attend 5 visits over one year. During these visits, they will receive surveys and physical assessments. They will also be asked to answer survey questions about their pain, recovery, and therapy through an email survey. The emailed surveys will be weekly for the first 3 months, then every 2 weeks until 6 months, then every 4 weeks until one year. There are 24 emailed surveys total.

Inclusion Criteria:

• Age 18 or older
• Unstable femoral or tibial shaft fracture treated with a locked intramedullary nail
• Willing and able to provide informed consent

Exclusion Criteria:

• Patients with weight-bearing or range of motion restrictions
• Patients treated surgically more than 3 weeks prior
• Previously non-ambulatory patients
• Pre-existing functional deficit of the lower extremities
• Patients over the age of 60 years
• Non-English-speaking patients
• Patients unwilling or unlikely to attend follow-up visits

Patients who sustain:

1. Polytraumatic injuries that preclude the use of assistive devices
2. Closed head injury limiting cognition
3. Nerve injury resulting in motor deficits