Role of a Self-Efficacy-based Model of Intervention: The LEARN Approach in Rehabilitation of Distal Radius Fracture

Distal radius fractures (DRFs) are one of the most commonly occurring fractures and contribute to high health care costs. Rehabilitation of DRFs is supported by weak but sufficiently relevant empirical evidence, which is rarely framed within a theoretical foundation. Most interventions focus on upper extremity physical function with less regard for potentially complex behavior exhibited by patients. Self-efficacy (SE) is a theoretical construct that has been used extensively to facilitate behavior change in rehabilitation. However, it has been applied less to acute injuries such as fractures. This article provides an overview of current knowledge about SE and its application in rehabilitation following DRF. We introduce the innovative LEARN approach (Learn exercise/activity, Encourage or cue, Address unpleasant symptoms, Reinforce from other's experience/Role model, Negate disability [say no to inability/promote confidence and a positive mindset]) for rehabilitation of a population with DRF. This approach integrates a previous framework for rehabilitation of DRFs to promote chronic pain with principles of SE. It is proposed that four sources of SE (performance accomplishment, vicarious experience, verbal persuasion, emotional arousal) used in the LEARN approach will result in better physical and functional outcomes during rehabilitation of DRF. Future research is needed to validate the LEARN approach as an SE-based model of intervention to guide evidence-based rehabilitation of DRFs.