RecruitingInterventional

Randomised evaluation of rehabilitation after acute proximal humerus (shoulder) fracture: the REACH study

Breaking the top of the arm bone at the shoulder is painful and can make everyday tasks difficult for months. Usually, the NHS refers patients for several face-to-face physiotherapy sessions. However, getting to hospital appointments can be stressful, especially for people who cannot drive or find public transport tough after a fall. The REACH study aims to find out if recovering at home is just as effective as traditional hospital physiotherapy. People who join the study are placed into one of two groups. One group has regular physiotherapy appointments. The other group receives a single detailed advice session with a specialist, along with a workbook and online video guides to follow at home. By comparing these two approaches, researchers hope to discover the most practical, comfortable, and effective recovery path for NHS patients in the future.

At a glance

Status

Recruiting

Sponsor

University of Exeter

Enrolment target

1,214

Start

12 Dec 2024

Estimated completion

12 Dec 2026

Proximal humerus fracture

What is this study about?

A break to the upper arm bone near the shoulder joint is known as a proximal humerus fracture. It is a common and painful injury, particularly for people over the age of 50 after a simple trip or fall. Healing takes time, and most people need to wear a sling while the bone begins to mend without surgery. Getting full movement back in the arm requires careful rehabilitation, which can take several months.

At present, the standard NHS care is to send patients for regular physiotherapy sessions at a clinic or hospital. While helpful, travelling to frequent appointments can be a real struggle. Many people cannot drive after an injury, and public transport can feel daunting when you are in pain or lacking confidence after a fall. Because of this, researchers want to see if supported home recovery could be just as good.

The REACH study compares regular physiotherapy appointments with a home-based programme. In the home programme, patients have one thorough session with a healthcare professional and then follow clear exercise videos and a printed booklet at home. If the home programme works well, it could save patients stressful journeys and help the NHS provide more flexible recovery options.

Key takeaways

Compares regular clinic physiotherapy against a home-based exercise guide for broken shoulders.
Open to people aged 16 and older who broke their shoulder within the last 21 days.
Only for shoulder fractures that are being treated without surgery.
Follow-up involves completing three simple questionnaires over six months.
Taking part helps the NHS understand the best, most practical way to treat broken shoulders.

Who may be eligible?

This study is open to adults and teenagers aged 16 and over who have recently broken the top part of their upper arm near the shoulder. The injury must have happened within the past 21 days, and doctors must have decided that it can heal naturally without an operation.

People cannot take part if they have nerve damage that causes major weakness or loss of feeling in the injured arm. You also cannot join if you have another injury to the same arm that would interfere with doing shoulder exercises, or if you had your break more than three weeks ago.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am aged 16 or older.
I have broken the top of my upper arm bone (shoulder fracture).
My fracture happened within the last 21 days.
My doctor has decided I do not need surgery for this break.
I do not have nerve damage affecting my injured arm.

Answer every question to see your result.

What does participation involve?

If you agree to take part, a computer will put you into one of two groups by chance. This is called randomisation. One group will be referred for standard face-to-face physiotherapy sessions at the hospital or clinic. The other group will have one detailed advice session with a trained specialist at the hospital, followed by doing their exercises at home using a booklet and online videos.

There are no extra medications or invasive tests involved. Whichever group you are in, researchers will stay in touch by asking you to fill out short questionnaires at two, four, and six months after joining. These surveys ask about your shoulder pain, how well your arm is moving, and how you are managing daily life. Your participation in the study lasts for six months in total.

Potential risks and benefits

The exercises in this study are already standard NHS care, so the risk of harm is very low. You might feel temporary muscle soreness or stiffness after doing your exercises, but the team will give you clear guidance on how to manage this safely. Taking part might not improve your recovery beyond standard treatment, but your experiences will help the NHS improve care for future patients. Joining is completely voluntary, and you can change your mind and leave the study at any time without your regular NHS medical care being affected.

Locations (34)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

Nottingham University Hospitals NHS Trust
City only
Nottingham, England
Barts Health NHS Trust
City only
London, England
Cambridge University Hospitals NHS Foundation Trust
City only
Cambridge, England
Airedale NHS Foundation Trust
City only
Keighley, England
University Hospitals of Leicester NHS Trust
City only
Leicester, England
The Dudley Group NHS Foundation Trust
Unverified
Dudley, England
Milton Keynes University Hospital NHS Foundation Trust
Unverified
Milton Keynes, England
Royal Berkshire NHS Foundation Trust
Unverified
Reading, England
South Tyneside and Sunderland NHS Foundation Trust
Unverified
Sunderland, England
Surrey and Sussex Healthcare NHS Trust
Unverified
Redhill, England
West Suffolk NHS Foundation Trust
Unverified
Bury St. Edmunds, England
NHS Forth Valley
Unverified
Stirling, Scotland

Common questions

Will I get to choose which rehabilitation group I am in?

No. A computer randomly puts you into one of the two groups to make sure the trial is fair and scientifically sound.

What happens if my shoulder hurts during the exercises?

Mild soreness can be normal during healing, but you will receive clear advice on pacing yourself and using simple pain relief.

Do I have to pay anything to take part?

No. All study materials, advice sessions, and NHS treatments are free of charge.

Can I leave the study if I find it too difficult?

Yes. You can withdraw at any time. Your normal NHS care and support will carry on as usual.

Who is running the REACH study?

The study is sponsored by the University of Exeter, organised by the University of Oxford, and funded by the National Institute for Health and Care Research (NIHR).

How to find out more

Kylea Draper

reach@ndorms.ox.ac.uk +44 (0)1865 223126 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.