Priority 12 from the Broken Bones of the Upper Limb in People over 50

UNCERTAINTY: Does a delay in physical rehabilitation of an upper limb fracture in people over 50 affect outcomes?  (JLA PSP Priority 12)
Overall ranking 12
JLA question ID 0093/12
Explanatory note Rehabilitation is important to ensure a patient achieves their best possible outcome following an upper limb fracture. Sometimes patients are not able to start this rehabilitation immediately due to factors such as physiotherapy waiting times. This question looks to determine if the delay in starting rehabilitation leads to poorer outcomes for these patients.
Evidence

Harding P, Rasekaba T, Smirneos L, Holland AE; Early mobilisation for elbow fractures in adults. Cochrane Database of Systematic Reviews 2011, Issue 6

Nash CE, Mickan SM, Del Mar CB, Glasziou PR. Resting injured limbs delays recovery: a systematic review. Journal of Family Practice 2004; 53(9): 706-712
Health Research Classification System category Injuries and Accidents
Extra information provided by this PSP
Original uncertainty examples When should physio start to maximise function often seems to be after discharge from ortho once muscle wasting and stiffness have set in? ~ What are the average waiting times to see a physiotherapist following fracture? ~ Taken too long to get physio - especially when you are told you need to get it moving - without paper advice how do you know that movements are safe?
Submitted by 12 x Healthcare Professionals, 14 x patients, 4 x Carers/Relatives
PSP information
PSP unique ID 0093
PSP name Broken Bones of the Upper Limb in People over 50 PSP
Total number of uncertainties identified by this PSP. 50  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 3 December 2018