Rehabilitation of proximal humerus fractures: An environmental scan of Canadian physiotherapy practice patterns
Bibliographic record
Abstract
<div>\n\n<p><small><b>Background:</b> Proximal humerus fractures (PHFs) are \ncommon injuries particularly in older adults. Evidence-based protocols \nfor PHF rehabilitation are lacking and physiotherapists use a variety of\n interventions.</small></p>\n\n<p><b>Purpose:</b> To determine practice patterns and perceptions of physiotherapists who treat adults with PHF in Ontario, Canada.</p>\n\n<p><b>Method:</b> A paper and pencil survey asking about respondent \ndemographics and management of Neer Group 1 (minimally/nondisplaced) and\n complex (displaced 3- and 4-part) PHF was mailed to 875 randomly \nselected physiotherapists who were registered with the College of \nPhysiotherapists of Ontario in 2013/2014 and working in practice areas \nlikely to be accessed by adults with PHF.</p>\n\n<p><b>Results:</b> The response rate was low (10%); 83 physiotherapists \ncompleted the survey - 80% had experience managing PHF. Respondents \ntreated 1-5 individuals with PHF annually; more treated Neer Group 1 PHF\n (89%) than complex PHF (68%). Most individuals with PHF were older than\n 60 years (64%), female (76%) and accessed physiotherapy through a \ndoctor’s referral (91%) more than 1 month post injury (33%).</p>\n\n<p><b>Main findings:</b> Physiotherapists manage PHF using \nmulti-component interventions and a minimum of 76% include the following\n elements: education and progression of passive, active assisted, active\n range of motion exercises and muscle retraining to build coordination \nand strength. Use of other elements was variable. The main factors \ninfluencing the treatment plan were the ability of the individual with \nPHF to comply, bone quality, and fracture type. Most respondents were \nunsure that there is sufficient PHF rehabilitation literature to guide \ntreatment.</p>\n\n<p><b>Conclusions:</b>This environmental scan is the first North \nAmerican study to document practice patterns and attitudes of \nphysiotherapists providing PHF rehabilitation. Elements used by \nphysiotherapists in Ontario treating small numbers of individuals with \nNeer Group 1 or complex PHFs each year align well with the limited PHF \nrehabilitation literature available.</p>\n\n<p><b>Potential implications:</b>Multi-disciplinary collaborations to \ndesign and conduct large, high quality, multi-centre prognostic studies \nand RCTs that evaluate the effectiveness of key aspects of non-surgical \nPHF rehabilitation in various patient groups are needed. Meanwhile, \nconsensus guidelines should be developed in the context of \nregion-specific physiotherapy service models to inform best practice in \nPHF rehabilitation management.</p>\n\n\n</div>
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".