EVAR Acceptability
Research type
Research Study
Full title
Early Virtual Ankle Rehabilitation (EVAR): A proof-of-concept feasibility study exploring patient acceptability using qualitative interviews with nested quantitative analysis.
IRAS ID
356614
Contact name
Ben Marson
Contact email
Sponsor organisation
University of Nottingham
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
We propose to investigate two different ways of delivering the same early rehabilitation program following ankle fracture surgery.
Ankle fractures comprise 20% of lower leg fractures and 14% of fracture-related hospitalisations. Rehabilitation is vital for healing and recovery; however, physiotherapy has traditionally been delayed until 6-8 weeks after surgery, by which time ankle stiffness, pain, and muscle loss have become notable.
The Early Motion And Directed Exercises (EMADE) programme introduced early ankle rehabilitation through advice and progressive exercises starting 2-weeks after surgery. Although safe and effective in accelerating recovery, it required additional hospital visits for physiotherapy reviews, which posed challenges for non-weightbearing patients and increased pressure on clinicians' time and clinic space.
In a COVID response, Nottingham University Hospitals NHS Trust (NUH) established a virtual clinic platform My-online-care (www.nuh.nhs.uk/my-online-care). Using this, we created the Early Virtual Ankle Rehabilitation (EVAR) program for remote physiotherapy. EVAR improves access while maintaining benefits.
• The study will explore patient acceptability of EVAR compared to EMADE.
• Thirty patients attending their first fracture clinic outpatient orthopaedic review, at 2-weeks post-surgery will be recruited into an early ankle rehabilitation programme (2-6 weeks after surgery).
• Baseline questionnaire will be completed.
• The early ankle rehabilitation programme runs for four weeks, between first and second fracture clinic attendance for orthopaedic reviews, usually weeks 2 to 6 post-surgery, respectively.
• All participants will receive the same rehabilitation, but the delivery mode (EVAR or EMADE) will be randomly assigned.
• At week 6 (during the second fracture clinic attendance), participants will complete questionnaires and interviews on their experiences and acceptability of care delivery.
• This study will be conducted by researchers from NUH and University of Nottingham (UoN). Nottingham Hospitals Charity funds the study.
• If EVAR proves acceptable, it could improve patient access and rehabilitation benefits while reducing hospital resources.
• The findings will inform whether to conduct a large multicentre trial on EVAR's clinical and economic effectiveness.REC name
West Midlands - Black Country Research Ethics Committee
REC reference
26/WM/0013
Date of REC Opinion
24 Mar 2026
REC opinion
Further Information Favourable Opinion