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Pelvic fractures can lead to disability and a poor health-related quality of life, thereby contributing to the burden of disease in South Africa. Rehabilitation plays an important role in improving the functional outcomes in patients with pelvic fractures. However, there is limited published research that presents optimal interventions and guidelines to improve outcomes in affected individuals.
The purpose of this study is to examine and map the range of and gaps in rehabilitation approaches and strategies used by health care professionals globally in the management of adult patients with pelvic fractures.
The synthesis of evidence will follow the framework outlined by Arksey and O’Malley and supported by the Joanna Briggs Institute. The identification of research questions; the identification of relevant studies; the selection of eligible studies; charting data; collating, summarizing, and reporting of the results; and consultation with relevant stakeholders will be undertaken. Peer-reviewed articles written in English; from quantitative, qualitative, and mixed methods studies; and searched through Google Scholar, MEDLINE, PubMed, and Cochrane Library will be considered. Studies eligible for selection will be full-text articles written in English about adult patients with pelvic fractures. Studies on children with pelvic fractures and on interventions following pathological pelvic fractures as well as opinion papers and commentaries will be excluded from the study. Rayyan software will be used for title and abstract screening to determine inclusion in the study and to improve collaboration between the reviewers. The Mixed Methods Appraisal Tool (version 2018) will be used to appraise the quality of the studies.
This protocol will guide a scoping review to examine and map the range of and gaps in rehabilitation approaches and strategies used by health care professionals globally in the management of adult patients with pelvic fractures, irrespective of level of care. Impairments, activity limitations, and participation restrictions in patients with pelvic fractures will be highlighted, which will give an indication of the rehabilitation needs of the affected individuals. Results of this review might provide evidence for health care professionals, policy makers, and scholars to aid rehabilitative care and further integration of patients into health care systems and community.
The rehabilitation needs of patients with pelvic fractures will be drawn from this review and will be presented in a flow diagram. Rehabilitation approaches and strategies in the management of patients with pelvic fractures will be identified to guide health care professionals in the promotion of quality health care for these patients.
OSF Registries osf.io/k6eg8; https://osf.io/k6eg8
PRR1-10.2196/38884
Pelvic fractures are mainly due to trauma [
The rate of survival of patients with pelvic fractures has increased significantly [
The aforementioned study explored the perspectives of patients on their health-related quality of life, following management of their pelvic fractures. Some of the challenges that were reported by the participants were poor mobility, chronic pain, lack of vitality, sexual dysfunction, and urinary and bowel incontinence. These challenges affected their day-to-day functioning at home, in society, in their communities, and at their workplaces. All these disabling outcomes resulted in low levels of physical health; psychological strain; poor social relations; and loss of independence in patients with pelvic fractures, regardless of the type of fracture. Pelvic fracture malunion leads to permanent disability in more than 65% of patients [
The increased survival rate of patients with pelvic fractures has been attributed to improved multidisciplinary health care management [
Early appropriate care optimizes health care and results in fewer complications in patients following pelvic fractures [
Even though pelvic fractures are a challenge to manage due to their complexity, no standardized comprehensive guidelines have been published to address the problems associated with them [
Therefore, the aim of this scoping review is to examine and map the range of and gaps in rehabilitation approaches and strategies used by health care professionals globally in the management of both in- and outpatients with pelvic fractures, irrespective of level of care.
This protocol has been registered with the Open Science Framework (osf.io/f9w3z). This study protocol follows the reporting guidelines provided in the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols ) statement [
PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) flow diagram [
The research question underpinning the review is “What rehabilitation approaches and strategies have been integrated in the management of adult patients with pelvic fractures?”
Subquestions that will guide the review are as follows:
What evidence exists on the rehabilitation approaches and strategies for skeletal stabilization of pelvic fractures, globally?
What evidence exists on the rehabilitation approaches and strategies for associated injuries (eg, rectal and urogenital, chest and abdomen, and other musculoskeletal systems) in adult patients with pelvic fractures?
What evidence exists on rehabilitation interventions for impairments (eg, pain, joint mobility and function, as well as emotional and psychological challenges) experienced by adult patients following pelvic fractures?
What evidence exists on rehabilitation interventions for functional disabilities, including mobility, urinary and bowel incontinence, and sexual dysfunction experienced by adult patients following pelvic fractures?
Identification of studies relevant to this review will be achieved in accordance with the Joanna Briggs Institute search strategy [
A pilot search using keywords to determine the feasibility of the study will be conducted (
The study will incorporate the Population, Concept, and Context (PCC) model to align the study selection with the research question [
The Inclusion and exclusion criteria for studies eligible for selection are presented in
Articles about adults (aged ≥18 years) with pelvic fractures
Global articles on rehabilitation approaches and strategies used during management
Full-text studies
Articles written in English
Articles on children with pelvic fractures
Articles on interventions following pathological pelvic fractures
Opinion papers
Commentaries
A data charting template (
Author(s)
Year of publication
Origin or country of origin (where the study was published or conducted)
Aims or purpose
Study population
Sample size (if applicable)
Methodology or methods
Intervention
Details of interventions (if applicable)
Outcomes (if applicable)
Details of these of outcomes (eg, how measured, if applicable)
Key findings that relate to the scoping review question(s)
Conclusions that relate to the scoping review questions
The data extracted from the studies will be guided by the research questions and subquestions. This will include evidence that exists on the rehabilitation approaches and strategies for each impairment as well as activity limitations and participation restrictions in adult patients with pelvic fractures. The stages of the scoping review promote transparency and allow reproducibility of the study by reducing the risk of bias and data duplication [
Quality appraisal will be undertaken in this scoping review to ensure that strong evidence is collected, which will help to create a trustworthy guide for follow-up research projects. Performance of quality appraisal is informed by a study by Daudt et al [
This protocol will guide a scoping review to examine and map the range of and gaps in rehabilitation approaches and strategies used by health care professionals globally in the management of both in- and outpatients with pelvic fractures, irrespective of level of care. Impairments, activity limitations and participation restrictions in patients with pelvic fractures will be highlighted, which will give an indication of the rehabilitation needs of the affected individuals. Results of this review might provide evidence for health care professionals, policy makers, and scholars to aid rehabilitative care and further integration of patients into health care systems and community.
These guidelines will inform the scoping review of examining the range of and gaps in the literature on the rehabilitation approaches and strategies for the management of patients with pelvic fractures. The rehabilitation needs of patients with pelvic fractures will also be drawn from the results of this review and presented in a flow diagram. This study might be used to inform health care professionals of the important aspects to be included in the assessment, management, and rehabilitation of patients with pelvic fractures. The results of this study might also be used to improve the physiotherapy curriculum. Approaches to health care management by health care professionals might be guided by the findings of this review. Health care professionals might be aware of the impact of pelvic fractures on the physical, mental, psychological, and socioeconomic status of the affected individuals. Health care professionals might be able to draw up relevant and patient-centered ward and home programs that can promote health-related quality of life in patients who had sustained pelvic fractures.
This scoping review is the first phase of a study that seeks to develop an interprofessional model of care for patients with pelvic fractures. It is hoped that this review will create awareness of the health care needs of patients with pelvic fractures. This awareness might prompt the health care professionals to set goals that will address most of the patients’ needs. The rehabilitation approaches and strategies used by the health care professionals globally as well as gaps in the literature will be identified [
The findings of the study will also provide evidence for health care policy makers to assist the stakeholders in addressing the needs of this population by rendering quality health care.
This scoping review protocol outlines steps that will guide the scoping review. This review will also identify and map studies that indicate the rehabilitation approaches and strategies in the management of patients with pelvic fractures. The results of this study may promote circulation of information and knowledge among health care professionals at various levels of health care.
Some articles might not be available in the databases that will be included in the study. Literature might also be limited since only articles written in English and available in full text will be considered for the study.
Data search strategy.
PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) fillable checklist.
Mixed Methods Appraisal Tool
Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols
Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews
The authors acknowledge the support provided by Levin Chetty and the librarian Nomgcobo Ntsham during the development of the search strategy and literature search from the databases.
Articles that will be included in the study will be deposited into the university repository and will be made available when necessary.
NAS and MDT conceptualized the study; NAS, MDT, and VC refined the methodology and drafted, reviewed, and edited the manuscript. All authors agreed to publish this paper.
None declared.