DOI: 10.4103/ijptr.ijptr_107_26 ISSN: 2666-3481

Functional Outcomes after Tibial Nailing: Role of Early Physiotherapy and Resistance Training

Abhinav Sathe, Shreya Singh, Prachi Sathe, D. Vijay Kumar

Abstract

Background:

Tibial shaft fractures are commonly managed with intramedullary nailing; however, postoperative pain, restricted joint mobility, muscle weakness, and impaired lower-limb function may delay recovery. Early physiotherapy combined with progressive resistance training has the potential to enhance rehabilitation outcomes, but evidence regarding its effectiveness in middle-aged patients remains limited. This study evaluated the effect of an early physiotherapy program incorporating progressive resistance training on functional recovery following tibial intramedullary nailing.

Materials and Methods:

Twenty-five individuals between 40 and 60 years of age who had undergone tibial intramedullary nailing were recruited for this prospective randomized trial. Using a random allocation procedure, participants were assigned either to an intervention group ( n = 15), which received an early physiotherapy program incorporating progressive resistance exercises, or to a control group ( n = 10) that underwent conventional postoperative rehabilitation. Treatment effectiveness was determined using the Lower Extremity Functional Scale (LEFS), visual analog scale (VAS) for pain, and goniometric assessment of joint mobility, with evaluations performed before rehabilitation and again after 8 weeks.

Results:

The experimental group demonstrated significantly greater improvements in functional recovery than the control group. LEFS scores increased from 40.46 ± 10.31 to 63.06 ± 4.86 ( P < 0.001), while VAS scores decreased from 8.40 ± 0.91 to 5.33 ± 0.97 ( P < 0.001). Significant improvements were also observed in knee flexion, ankle dorsiflexion, and ankle plantarflexion (all P < 0.001).

Conclusion:

Early physiotherapy combined with progressive resistance training significantly improved pain, joint mobility, and lower-limb function following tibial intramedullary nailing, supporting its incorporation into routine postoperative rehabilitation.

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