Physiotherapy assessment and treatment of patients with tibial external fixator: a systematic scoping review

Abstract

Purpose

To map evidence regarding physiotherapy assessment and treatment of patients with tibial external fixator (EF), and to point out literature gaps for further research.

Methods

Systematic scoping review conducted in four databases. We included both experimental and non-experimental studies involving patients with tibial EF and outcomes of interest. We recorded study design, population, sample size, sample age, reason for EF use, type of surgery, type of EF used, instruments used for assessing function, pain, quality of life, satisfaction, psychosocial aspects, and physiotherapy treatment descriptions from included studies. We categorised data accordingly to outcomes assessed and physiotherapy treatments description.

Results

Eighty-six studies were included involving 3070 patients. Causes of fixator use were traumatic conditions, acquired and congenital deformities, and non-traumatic conditions, like compartmental osteoarthritis. Function was assessed in about three-quarters of included studies, though other outcomes were not presented in most studies. Only one study described satisfactorily the physiotherapy treatment. Almost half of the studies did not provide any description of the rehabilitation process.

Conclusions

There is little evidence about the assessment of function, pain, quality of life, satisfaction, psychosocial aspects, and other outcomes in tibial EF patients. Physiotherapy treatment in these patients is poorly reported.Protocol registration: Open Science Framework: doi:10.17605/OSF.IO/UT2DA

IMPLICATIONS FOR REHABILITATION

• Rehabilitation programmes and research should consider that most studies with tibial external fixator (EF) patients did not evaluate outcomes routinely used in physiotherapy assessment.

• Rehabilitation programmes should consider that the instruments used in evaluation of tibial EF patients have unknown measurement properties.

• Rehabilitation programmes should consider that treatment of patients with tibial EF involves different types of interventions, however, they are poorly described or not described in most studies.

Keywords:

• External fixator
• Tibia
• rehabilitation
• assessment
• intervations
• scoping review

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

MSS is supported by a doctorate scholarship from COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR, Brazil. The funder played no role in the design, conduct, or reporting of this study.