A recent publication from Ferreira AM et al aimed to map the profile of current research on fracture management. Using the Physiotherapy Evidence Database, PEDro to access high-quality evidence evaluating the effectiveness of physiotherapy interventions, the authors charted study designs, which body parts are being studied, and the geographical regions studies were conducted.

Authors Aline Miranda Ferreira and Raquel Metzker Mendes Sugano answered a few questions about their study.

 

Why did you conduct the study?

Bone fractures are a major global health challenge, causing significant disability and high healthcare costs. To ensure patients receive the best possible care, evidence-based practice is the gold standard. We wanted to find out if physiotherapists have enough high-quality scientific evidence to guide their decisions when treating fractures.

 

Was there any existing research that already addressed this question?

While we know that fractures are a top priority for global health, as highlighted in the World Health Organization’s “Rehabilitation 2030” initiative, the specific landscape of physiotherapy evidence for these conditions remained unclear. Before the study, it wasn’t fully established if the quantity and quality of research were sufficient across different body segments and geographical regions.

 

What did you do in your study?

The team performed a comprehensive mapping of evidence on PEDro. We searched for all studies indexed up to April 2025 using the term “fracture” within the musculoskeletal and orthopedic filters. Two researchers independently reviewed the results to select clinical trials, systematic reviews, and clinical practice guidelines focused on physiotherapy for fractures.

 

What did you measure?

We analysed the number and type of studies, anatomical segments (body parts) addressed, decade of publication, and geographical distribution of the trials. Methodological quality of the clinical trials using the PEDro Scale was also assessed.

 

What did the study find?

The findings revealed some important gaps. Firstly, there is limited evidence: of all musculoskeletal and orthopedic research on PEDro, fracture-related studies represented only 3.2%. Next, the regions of the body that articles most concentrated on were the hip (35.7%) and wrist/fingers (23.1%), leaving other areas like the knee femur and humeral shaft underrepresented. Regarding the quality of research, the average total PEDro score for methodological quality in clinical trials was 5.35 out of 10. Furthermore, there were only 12 evidence-based clinical practice guidelines available. Finally, scientific production was heavily dominated by developed regions such as Europe, Asia, and North America. Representation from South America (1.2%), Africa (0.2%), and Central America (0%) was extremely low.

 

What does your study recommend?

To support evidence-based physiotherapy, future research needs to increase the methodological rigor of clinical trials to improve their reliability. Research also needs to expand their focus to target understudied body segments and critical clinical issues like early mobilization and functional recovery. Our study also shows that support is needed to conduct and disseminate research from developing regions, where the burden of trauma is high but local evidence is still scarce.

This study serves as a call to action for more high-quality research in the field to enable physiotherapists to implement evidence-based care for patients following fracture.

 

Ferreira AM, et al. 2025. Does the scientific literature on fractures support evidence-based physiotherapy? Mapping the evidence on the PEDro platform. Physiotherapy Research International: e70110. DOI: https://doi.org/10.1002/pri.70110 .