A Cross-Sectional Survey of Physiotherapists’ Management of Adults with Traumatic Elbow Injuries and Post-Traumatic Elbow Stiffness in the United Kingdom

Objectives To determine the physiotherapy management of patients with traumatic elbow injuries and post-traumatic elbow stiffness (PTES) in the United Kingdom (UK). Design An online cross-sectional survey of UK-based Health and Care Professions Council (HCPC) registered physiotherapists. Methods Physiotherapists were invited via phone, email, social media, and a newsletter advert over an 80-day period. The survey contained 25 questions (18 closed, with 7 ‘other' options to allow for free text) exploring patient characteristics, and physiotherapists' assessment and treatment approaches. Data were narratively analysed. Results Seventy-one physiotherapists responded. The most common method for assessing stiffness was clinical assessment (e.g. goniometer measurement), reported by 70/71 (99%) participants. Active range-of-movement exercises in the immediate, acute phase (0-6 weeks) were used by 68/71 (98%). The most frequently reported challenges were reduced elbow extension (64/71, 90%) and pain (59/71, 83%). Confidence in treating this patient group varied, with 42/71 (58%) rating their confidence above 5 on a ten-point scale, where 1 was ‘not at all' and 10 was ‘very confident'. Conclusion UK physiotherapists commonly use range-of-movement exercises in the management of traumatic elbow injuries during the immediate, acute phase (0-6 weeks), and clinical assessment is routinely employed during assessment. However, the small sample size limits the generalisability of current findings, and further research involving larger cohorts would be required to evaluate the effectiveness of interventions and to inform the development of a comprehensive rehabilitation programme. Contribution of the paper •Provides a preliminary overview of current UK physiotherapy practices for managing traumatic elbow injuries and post-traumatic elbow stiffness (PTES). •Identifies common approaches to assessment and treatment, including clinical and functional assessment, active range-of-movement exercises, stretching, strengthening and home exercise programmes. •Highlights variation in clinical practice, particularly in the use of patient-reported outcome measures (PROMs) and advice relating to return to work and previous activities. •Provides insight into the role of education and psychosocial factors, including physiotherapists' perceptions of kinesiophobia in the development and management of PTES. •Highlights potential opportunities to improve consistency in assessment, outcome measurement and rehabilitation practice. •Provides a basis for future research and multidisciplinary work to develop and evaluate evidence-informed rehabilitation strategies for traumatic elbow injuries and PTES.