REACH Randomised evaluation of rehabilitation after acute proximal humerus fracture; a multi-centre, non inferiority, randomised trial to compare the clinical and cost-effectiveness of a self-directed rehabilitation programme versus physiotherapist-supervised rehabilitation ( usual care) for adults with proximal humerus fracture/ Randomised evaluation of rehabilitation after acute proximal humerus fracture

A break to the bone of the upper arm at the shoulder is a painful injury. It results in a sudden loss of use of the arm with recovery taking many months. Most injuries occur in people over 50 years of age after a fall, due to reduced bone strength, and are usually treated with a sling, although some fractures may need surgery. Currently, people are asked to see a physiotherapist a number of times to help with recovery after a proximal humerus fracture. Attending physiotherapy appointments can however be very difficult, especially for people who live alone or have poor social support networks. Driving is not possible and public transport is a struggle due to low confidence after a fall. A one-off advice session, with clear verbal and written instructions and videos of exercises patients can do at home, could be an alternative to attending physiotherapy clinic for multiple sessions. Providing high-quality advice so people can manage their own recovery could be less of a burden for patients and their carers who might use fewer healthcare resources. Before widely using an alternative advice approach, it is important to know that people receiving a one-off advice session would not be disadvantaged in their recovery compared with people having a series of physiotherapy appointments. The REACH trial aims to find out the best way to support recovery and will compare the recovery of patients who receive a single advice session with a health professional and access to a workbook and videos to use at home, with the recovery of patients who are referred to see a physiotherapist. After 6 months, patients’ shoulder function and quality of life will be compared between the two groups.