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EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial)

Ceri Battle, Timothy Driscoll Orcid Logo, Deborah Fitzsimmons Orcid Logo, Shaun Harris Orcid Logo, Fiona Lecky, Claire O'Neill Orcid Logo, Alan Watkins Orcid Logo, Jane Barnett, Susan Davies, Hayley Hutchings Orcid Logo, Kate Jones, Andrew Eglington, Sophie Place, Hannah Toghill, Katie Foster, Bethan Uzzell, Elizabeth Ford, Mark Baker, Sophie Lewis, Sara Davies, Sarah Nicholls, Amy Charnock, Claire Watkins, Sarah-Jane Garside, Jeannie Bishop, Thomas Dawson, Jessica Pendlebury, Reece Doonan

Injury, Volume: 56, Issue: 5, Start page: 112075

Swansea University Authors: Ceri Battle, Timothy Driscoll Orcid Logo, Deborah Fitzsimmons Orcid Logo, Shaun Harris Orcid Logo, Claire O'Neill Orcid Logo, Alan Watkins Orcid Logo, Hayley Hutchings Orcid Logo

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DOI (Published version): 10.1016/j.injury.2024.112075

Abstract

Introduction: The aim of this trial was to investigate the impact of early thoracic and shoulder girdle exercises on chronic pain and Health-Related Quality of Life in patients with blunt chest wall trauma, when compared to normal care. Methods: A multi-centre, parallel, randomised controlled trial,...

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Published in: Injury
ISSN: 0020-1383 1879-0267
Published: Elsevier Ltd 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa68466
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Methods: A multi-centre, parallel, randomised controlled trial, in which adult patients presenting to hospital with blunt chest wall trauma were allocated to either control or intervention group. The intervention was an exercise programme consisting of four simple thoracic and shoulder girdle exercises, completed for one week. Outcomes measures included prevalence and severity of chronic pain using the Brief Pain Inventory, health-related quality of life using EQ-5D-5 L, and cost effectiveness, measured at initial presentation and three months post-injury. Results: 360 participants were recruited. Participants&#x2019; mean age was 63.6 years (standard deviation (SD): 17.9 years) and 213 (59.8 %) were men. After loss-to-follow-up, the survey response rate at three months was 73.0 % (251/344 participants). The primary analysis, for chronic pain prevalence at three months post-injury, found no statistically significant differences between intervention and control groups, with lower rates in the control (intervention: 35/126 (27.8 %), control: 20/117 (17.1 %); adjusted odds ratio 1.862; 95 % CI: 0.892 to 3.893, p = 0.098). There were no statistically significant differences between intervention and control groups for pain severity at three months post-injury, (intervention mean (SD): 2.15 (2.49), control: 1.81 (2.10); adjusted difference 0.196, 95 % CI:0.340 to 0.731; p = 0.473); or Health-Related Quality of Life (intervention mean (SD): 0.715 (0.291), control: 0.704 (0.265); adjusted difference: 0.030; 95 % CI:0.033 to 0.094; p = 0.350). The health economic analysis found the intervention was associated with higher costs compared to normal care. Conclusion: The results of this trial did not support a &#x2018;one-size fits all&#x2019; simple, early exercise programme for patients with blunt chest wall trauma. Future research should consider the impact of a personalised exercise programme, commenced by the patient at least one week post-injury.</abstract><type>Journal Article</type><journal>Injury</journal><volume>56</volume><journalNumber>5</journalNumber><paginationStart>112075</paginationStart><paginationEnd/><publisher>Elsevier Ltd</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0020-1383</issnPrint><issnElectronic>1879-0267</issnElectronic><keywords>Blunt chest trauma; Early exercise; Chronic pain; Health-related quality of life</keywords><publishedDay>7</publishedDay><publishedMonth>5</publishedMonth><publishedYear>2025</publishedYear><publishedDate>2025-05-07</publishedDate><doi>10.1016/j.injury.2024.112075</doi><url/><notes/><college>COLLEGE NANME</college><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><apcterm>Other</apcterm><funders>This study was supported by Health and Care Research Wales on behalf of Welsh Government (Grant number RfPPB 20-1738).</funders><projectreference/><lastEdited>2025-05-12T11:45:38.1564229</lastEdited><Created>2024-12-05T11:52:45.0666389</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Ceri</firstname><surname>Battle</surname><order>1</order></author><author><firstname>Timothy</firstname><surname>Driscoll</surname><orcid>0000-0001-9879-2509</orcid><order>2</order></author><author><firstname>Deborah</firstname><surname>Fitzsimmons</surname><orcid>0000-0002-7286-8410</orcid><order>3</order></author><author><firstname>Shaun</firstname><surname>Harris</surname><orcid>0000-0001-7724-6621</orcid><order>4</order></author><author><firstname>Fiona</firstname><surname>Lecky</surname><order>5</order></author><author><firstname>Claire</firstname><surname>O'Neill</surname><orcid>0000-0003-3497-0235</orcid><order>6</order></author><author><firstname>Alan</firstname><surname>Watkins</surname><orcid>0000-0003-3804-1943</orcid><order>7</order></author><author><firstname>Jane</firstname><surname>Barnett</surname><order>8</order></author><author><firstname>Susan</firstname><surname>Davies</surname><order>9</order></author><author><firstname>Hayley</firstname><surname>Hutchings</surname><orcid>0000-0003-4155-1741</orcid><order>10</order></author><author><firstname>Kate</firstname><surname>Jones</surname><order>11</order></author><author><firstname>Andrew</firstname><surname>Eglington</surname><order>12</order></author><author><firstname>Sophie</firstname><surname>Place</surname><order>13</order></author><author><firstname>Hannah</firstname><surname>Toghill</surname><order>14</order></author><author><firstname>Katie</firstname><surname>Foster</surname><order>15</order></author><author><firstname>Bethan</firstname><surname>Uzzell</surname><order>16</order></author><author><firstname>Elizabeth</firstname><surname>Ford</surname><order>17</order></author><author><firstname>Mark</firstname><surname>Baker</surname><order>18</order></author><author><firstname>Sophie</firstname><surname>Lewis</surname><order>19</order></author><author><firstname>Sara</firstname><surname>Davies</surname><order>20</order></author><author><firstname>Sarah</firstname><surname>Nicholls</surname><order>21</order></author><author><firstname>Amy</firstname><surname>Charnock</surname><order>22</order></author><author><firstname>Claire</firstname><surname>Watkins</surname><order>23</order></author><author><firstname>Sarah-Jane</firstname><surname>Garside</surname><order>24</order></author><author><firstname>Jeannie</firstname><surname>Bishop</surname><order>25</order></author><author><firstname>Thomas</firstname><surname>Dawson</surname><order>26</order></author><author><firstname>Jessica</firstname><surname>Pendlebury</surname><order>27</order></author><author><firstname>Reece</firstname><surname>Doonan</surname><order>28</order></author></authors><documents><document><filename>68466__34246__228b65fb94ef43178b23d17b3ad2fc68.pdf</filename><originalFilename>68466.VOR.pdf</originalFilename><uploaded>2025-05-12T11:42:05.0652958</uploaded><type>Output</type><contentLength>1351210</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2024 The Authors. 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spelling 2025-05-12T11:45:38.1564229 v2 68466 2024-12-05 EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial) 9ae21f1afb903db3c39684cd47b94760 Ceri Battle Ceri Battle true false 2be5c329c44d14550ceac4934fcb409e 0000-0001-9879-2509 Timothy Driscoll Timothy Driscoll true false e900d99a0977beccf607233b10c66b43 0000-0002-7286-8410 Deborah Fitzsimmons Deborah Fitzsimmons true false 10b1bd08dbad1f2681ff1e527af9f9a3 0000-0001-7724-6621 Shaun Harris Shaun Harris true false b6ee9140bc0cf54b94165f477a530f9e 0000-0003-3497-0235 Claire O'Neill Claire O'Neill true false 81fc05c9333d9df41b041157437bcc2f 0000-0003-3804-1943 Alan Watkins Alan Watkins true false bdf5d5f154d339dd92bb25884b7c3652 0000-0003-4155-1741 Hayley Hutchings Hayley Hutchings true false 2024-12-05 Introduction: The aim of this trial was to investigate the impact of early thoracic and shoulder girdle exercises on chronic pain and Health-Related Quality of Life in patients with blunt chest wall trauma, when compared to normal care. Methods: A multi-centre, parallel, randomised controlled trial, in which adult patients presenting to hospital with blunt chest wall trauma were allocated to either control or intervention group. The intervention was an exercise programme consisting of four simple thoracic and shoulder girdle exercises, completed for one week. Outcomes measures included prevalence and severity of chronic pain using the Brief Pain Inventory, health-related quality of life using EQ-5D-5 L, and cost effectiveness, measured at initial presentation and three months post-injury. Results: 360 participants were recruited. Participants’ mean age was 63.6 years (standard deviation (SD): 17.9 years) and 213 (59.8 %) were men. After loss-to-follow-up, the survey response rate at three months was 73.0 % (251/344 participants). The primary analysis, for chronic pain prevalence at three months post-injury, found no statistically significant differences between intervention and control groups, with lower rates in the control (intervention: 35/126 (27.8 %), control: 20/117 (17.1 %); adjusted odds ratio 1.862; 95 % CI: 0.892 to 3.893, p = 0.098). There were no statistically significant differences between intervention and control groups for pain severity at three months post-injury, (intervention mean (SD): 2.15 (2.49), control: 1.81 (2.10); adjusted difference 0.196, 95 % CI:0.340 to 0.731; p = 0.473); or Health-Related Quality of Life (intervention mean (SD): 0.715 (0.291), control: 0.704 (0.265); adjusted difference: 0.030; 95 % CI:0.033 to 0.094; p = 0.350). The health economic analysis found the intervention was associated with higher costs compared to normal care. Conclusion: The results of this trial did not support a ‘one-size fits all’ simple, early exercise programme for patients with blunt chest wall trauma. Future research should consider the impact of a personalised exercise programme, commenced by the patient at least one week post-injury. Journal Article Injury 56 5 112075 Elsevier Ltd 0020-1383 1879-0267 Blunt chest trauma; Early exercise; Chronic pain; Health-related quality of life 7 5 2025 2025-05-07 10.1016/j.injury.2024.112075 COLLEGE NANME COLLEGE CODE Swansea University Other This study was supported by Health and Care Research Wales on behalf of Welsh Government (Grant number RfPPB 20-1738). 2025-05-12T11:45:38.1564229 2024-12-05T11:52:45.0666389 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Ceri Battle 1 Timothy Driscoll 0000-0001-9879-2509 2 Deborah Fitzsimmons 0000-0002-7286-8410 3 Shaun Harris 0000-0001-7724-6621 4 Fiona Lecky 5 Claire O'Neill 0000-0003-3497-0235 6 Alan Watkins 0000-0003-3804-1943 7 Jane Barnett 8 Susan Davies 9 Hayley Hutchings 0000-0003-4155-1741 10 Kate Jones 11 Andrew Eglington 12 Sophie Place 13 Hannah Toghill 14 Katie Foster 15 Bethan Uzzell 16 Elizabeth Ford 17 Mark Baker 18 Sophie Lewis 19 Sara Davies 20 Sarah Nicholls 21 Amy Charnock 22 Claire Watkins 23 Sarah-Jane Garside 24 Jeannie Bishop 25 Thomas Dawson 26 Jessica Pendlebury 27 Reece Doonan 28 68466__34246__228b65fb94ef43178b23d17b3ad2fc68.pdf 68466.VOR.pdf 2025-05-12T11:42:05.0652958 Output 1351210 application/pdf Version of Record true © 2024 The Authors. This is an open access article under the CC BY-NC-ND license. true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
title EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial)
spellingShingle EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial)
Ceri Battle
Timothy Driscoll
Deborah Fitzsimmons
Shaun Harris
Claire O'Neill
Alan Watkins
Hayley Hutchings
title_short EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial)
title_full EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial)
title_fullStr EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial)
title_full_unstemmed EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial)
title_sort EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial)
author_id_str_mv 9ae21f1afb903db3c39684cd47b94760
2be5c329c44d14550ceac4934fcb409e
e900d99a0977beccf607233b10c66b43
10b1bd08dbad1f2681ff1e527af9f9a3
b6ee9140bc0cf54b94165f477a530f9e
81fc05c9333d9df41b041157437bcc2f
bdf5d5f154d339dd92bb25884b7c3652
author_id_fullname_str_mv 9ae21f1afb903db3c39684cd47b94760_***_Ceri Battle
2be5c329c44d14550ceac4934fcb409e_***_Timothy Driscoll
e900d99a0977beccf607233b10c66b43_***_Deborah Fitzsimmons
10b1bd08dbad1f2681ff1e527af9f9a3_***_Shaun Harris
b6ee9140bc0cf54b94165f477a530f9e_***_Claire O'Neill
81fc05c9333d9df41b041157437bcc2f_***_Alan Watkins
bdf5d5f154d339dd92bb25884b7c3652_***_Hayley Hutchings
author Ceri Battle
Timothy Driscoll
Deborah Fitzsimmons
Shaun Harris
Claire O'Neill
Alan Watkins
Hayley Hutchings
author2 Ceri Battle
Timothy Driscoll
Deborah Fitzsimmons
Shaun Harris
Fiona Lecky
Claire O'Neill
Alan Watkins
Jane Barnett
Susan Davies
Hayley Hutchings
Kate Jones
Andrew Eglington
Sophie Place
Hannah Toghill
Katie Foster
Bethan Uzzell
Elizabeth Ford
Mark Baker
Sophie Lewis
Sara Davies
Sarah Nicholls
Amy Charnock
Claire Watkins
Sarah-Jane Garside
Jeannie Bishop
Thomas Dawson
Jessica Pendlebury
Reece Doonan
format Journal article
container_title Injury
container_volume 56
container_issue 5
container_start_page 112075
publishDate 2025
institution Swansea University
issn 0020-1383
1879-0267
doi_str_mv 10.1016/j.injury.2024.112075
publisher Elsevier Ltd
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description Introduction: The aim of this trial was to investigate the impact of early thoracic and shoulder girdle exercises on chronic pain and Health-Related Quality of Life in patients with blunt chest wall trauma, when compared to normal care. Methods: A multi-centre, parallel, randomised controlled trial, in which adult patients presenting to hospital with blunt chest wall trauma were allocated to either control or intervention group. The intervention was an exercise programme consisting of four simple thoracic and shoulder girdle exercises, completed for one week. Outcomes measures included prevalence and severity of chronic pain using the Brief Pain Inventory, health-related quality of life using EQ-5D-5 L, and cost effectiveness, measured at initial presentation and three months post-injury. Results: 360 participants were recruited. Participants’ mean age was 63.6 years (standard deviation (SD): 17.9 years) and 213 (59.8 %) were men. After loss-to-follow-up, the survey response rate at three months was 73.0 % (251/344 participants). The primary analysis, for chronic pain prevalence at three months post-injury, found no statistically significant differences between intervention and control groups, with lower rates in the control (intervention: 35/126 (27.8 %), control: 20/117 (17.1 %); adjusted odds ratio 1.862; 95 % CI: 0.892 to 3.893, p = 0.098). There were no statistically significant differences between intervention and control groups for pain severity at three months post-injury, (intervention mean (SD): 2.15 (2.49), control: 1.81 (2.10); adjusted difference 0.196, 95 % CI:0.340 to 0.731; p = 0.473); or Health-Related Quality of Life (intervention mean (SD): 0.715 (0.291), control: 0.704 (0.265); adjusted difference: 0.030; 95 % CI:0.033 to 0.094; p = 0.350). The health economic analysis found the intervention was associated with higher costs compared to normal care. Conclusion: The results of this trial did not support a ‘one-size fits all’ simple, early exercise programme for patients with blunt chest wall trauma. Future research should consider the impact of a personalised exercise programme, commenced by the patient at least one week post-injury.
published_date 2025-05-07T05:25:34Z
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score 11.444327

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