A Novel Stress Fracture Rehabilitation Program: A Pilot Study

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation Science

Background:

• Tibia stress fractures (SFx) are a common cause of military readiness limitations.
• Current rehabilitation programs lack scientific validation for objectively fostering SFx recovery.
• There is a need for evidence-based interventions to improve healing and return-to-duty timelines.

Purpose of the Study:

• To evaluate the feasibility of a novel Graduated Exercise Program (GEP) for tibia stress fracture rehabilitation.
• To test the hypothesis that programmed rest enhances the osteogenic response during recovery.
• To assess the impact of autonomy support on program adherence and outcomes.

Main Methods:

• A pilot randomized controlled trial comparing GEP to standard care.
• GEP involved split exercise sessions and 5 days of rest per stage, alongside autonomy support.
• Outcome measures included adherence, objective/subjective exercise data, pain, and autonomy support.

Main Results:

• The GEP demonstrated feasibility with high participant compliance.
• Measurement, support, and self-reporting parameters were successfully implemented.
• Barriers to recruitment and retention were identified, with proposed solutions.

Conclusions:

• The Graduated Exercise Program (GEP) with autonomy support is a feasible approach for tibia stress fracture rehabilitation.
• This pilot study provides a foundation for a larger, definitive trial.
• Addressing recruitment/retention barriers, starting with unit support, is crucial for future implementation.