{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:01:57Z","timestamp":1790182917794,"version":"4.1.0"},"reference-count":43,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"unspecified","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Tianjin Nursing Association of China","award":["tjhlky2024QN13"],"award-info":[{"award-number":["tjhlky2024QN13"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,9,11]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterise longitudinal trajectories of adherence to postoperative rehabilitation training and identify their predictors among patients with traumatic fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This study adopted a longitudinal design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A tertiary hospital in Tianjin, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 317 patients with traumatic fractures who underwent postoperative rehabilitation training in the Department of Trauma Orthopedics between April 2024 and January 2025 were recruited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Patients were assessed using the General Information Questionnaire, Functional Exercise Compliance Scale for Orthopedic Patients, Modified Barthel Index, 13-item Sense of Coherence (SOC) Scale and Social Support Rating Scale at baseline and 4, 12 and 24 weeks after hospital discharge. Latent growth mixture modelling was used to identify longitudinal trajectories, and regression analysis was performed to determine predictors of trajectory-group membership.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean rehabilitation training adherence scores at baseline and 4, 12 and 24 weeks after hospital discharge were 52.97\u00b15.94, 53.07\u00b11.57, 54.46\u00b11.68 and 55.05\u00b15.24, respectively. Three distinct adherence trajectories were identified: a low-adherence increasing group (n=79, 24.9%), a moderate-adherence stable group (n=85, 26.8%) and a high-adherence declining group (n=153, 48.3%). Occupation, monthly income, place of residence, rehabilitation location, SOC and social support were significantly associated with trajectory-group membership.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Three distinct trajectories of adherence to postoperative rehabilitation training were identified among adults with traumatic fractures, with the high-adherence declining group comprising the largest proportion. This group warrants particular attention and continued monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-115239","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:10:25Z","timestamp":1790179825000},"page":"e115239","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative rehabilitation training adherence longitudinal trajectories and predictors in traumatic fracture patients: a longitudinal study in China"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5661-3741","authenticated-orcid":false,"given":"Hui","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of No. 2 Upper Extremity Traumatology, Tianjin Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruzhen","family":"Luo","sequence":"additional","affiliation":[{"name":"Tianjin Medical University, School of Nursing, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihong","family":"Yu","sequence":"additional","affiliation":[{"name":"Nursing Department, Tianjin Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of No. 2 Upper Extremity Traumatology, Tianjin Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"2026092309101511000_16.9.e115239.1","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-020-0706-y"},{"key":"2026092309101511000_16.9.e115239.2","doi-asserted-by":"crossref","first-page":"e807","DOI":"10.1016\/S2214-109X(17)30222-X","article-title":"National incidence of traumatic fractures in China: a retrospective survey of 512\u2008187 individuals","volume":"5","author":"Chen","year":"2017","journal-title":"Lancet Glob Health"},{"key":"2026092309101511000_16.9.e115239.3","doi-asserted-by":"crossref","first-page":"2167","DOI":"10.1007\/s00198-020-05496-9","article-title":"Traumatic fractures in China from 2012 to 2014: a National Survey of 512,187 individuals","volume":"31","author":"Lv","year":"2020","journal-title":"Osteoporos Int"},{"key":"2026092309101511000_16.9.e115239.4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0227907","article-title":"The socioeconomic impact of orthopaedic trauma: A systematic review and meta-analysis","volume":"15","author":"O\u2019Hara","year":"2020","journal-title":"PLoS ONE"},{"key":"2026092309101511000_16.9.e115239.5","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1002\/jbmr.3640","article-title":"The Cost of Osteoporosis, Osteopenia, and Associated Fractures in Australia in 2017","volume":"34","author":"Tatangelo","year":"2019","journal-title":"J Bone Miner Res"},{"key":"2026092309101511000_16.9.e115239.6","doi-asserted-by":"crossref","unstructured":"Silvester L , Higo A , Kearney RS , et al . 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