Proefschrift

A protocol for permissive weight bearing during allied health therapy in pelvic and the lower extremities fractures 61 In case of limited conditional abilities such as lack of joint mobility, muscle strength, joint stability, endurance and/or postural balance, trade-offs have to be made regarding the above items. The patient will have to give a priority as to which of the above aspects are most important to him. Pilot study In order to assess the level of weight bearing and the rate of complications when using the PROMETHEUS protocol, a pilot study was conducted in 2015, which included surgically treated trauma patients with (peri)- or intra-articular fractures of the pelvis and lower extremities who were admitted to our rehabilitation center between 2005 and 2015. Patients with pathological fractures, shaft fractures treated with intra-medullary nailing, or fractures treated with external fixation, and patients with amputations in the area of the lower extremity, were excluded. Also excluded were patients with cognitive dysfunction, due to the consequences of a severe neurotrauma or to concomitant or drug-based mental illness. All data in the study were collected retrospectively from the electronic patient records, by one researcher. Demographics of patients retrieved included age, gender, date of accident, type of fracture and type of fixation. Primary outcome measures included the time from surgery till full weight bearing and the total number and type of complications at 1-year follow-up. Type of complications were defined separately, comprising adverse events that occurred during one year of the PWB regime. The rate of individual complications was also recorded. The medical ethics committee approved this study, and informed consent was given by all patients. Statistical analysis Statistical analysis was performed with IBM SPSS Statistics, Version 23.0, Armonk, New York. Descriptive statistics were used to describe the demographic data and baseline characteristics of the entire population. Results are presented as frequencies and percentages. Data are described as median values, interquartile ranges [x,y] and the minimum and the maximum [min-max]. Binary logistic regression was performed to assess independent predictors of late full weight bearing (>12 weeks) throughout both PWB and RWB groups. The level of statistical significance was set at ɲ=0.05.

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