Does the Scientific Literature on Fractures Support Evidence-Based Physiotherapy? Mapping the Evidence on the PEDro Platform

Abstract

Background: Bone fractures impose significant healthcare costs and are among the musculoskeletal conditions most requiring rehabilitation. Evidence-based practice (EBP) is the recommended approach for ensuring quality and consistency of care. However, does the scientific literature on fractures adequately support evidence-based physiotherapy?. Purpose: To map the profile of fracture studies indexed on the PEDro platform, focusing on study designs, body segments studied, publication decade, and geographical distribution. Methods: Two authors independently extracted data from the PEDro platform using the term fracture in the musculoskeletal and orthopedic subdiscipline filter. Studies without abstracts or full articles available and those not primarily focused on fractures were excluded. Results: Six hundred sixty-seven met the inclusion criteria, representing 3.2% of all musculoskeletal and orthopedic studies. Twelve clinical practice guidelines, 141 systematic reviews and 514 CTs were identified. The studies prioritize the hip (35.7%) and wrist (23.1%). Clinical trials were concentrated in Europe (47.8%), Asia (24.9%), North America (21%), and Oceania (11%), with few studies from South America (1.2%), Africa (0.2%) and none from Central America. The average PEDro scale score was 5.35 ± 1.81, with a peak in study production observed in the 2010s. Conclusion: Fracture studies on the PEDro platform are limited in number and quality. Many segments lack clinical guidelines and systematic reviews or trials. The geographic distribution reflects disparities in scientific production, favoring developed regions. These findings underscore the need for improved research and dissemination efforts, particularly in regions with lower representation.