Compliance with Post-Operative Physiotherapy Among Orthopaedic Patients at Enugu State University Teaching Hospital

Post-operative physiotherapy is a critical determinant of functional recovery following orthopaedic surgery, yet patient compliance with prescribed rehabilitation programmes is frequently suboptimal in Nigerian public hospitals. This prospective observational study investigates compliance with post-operative physiotherapy and its determinants among orthopaedic surgical patients at Enugu State University Teaching Hospital (ESUTH), South East Nigeria. Over nine months, 120 patients who have undergone lower limb orthopaedic surgery will be enrolled and monitored for adherence to physiotherapy attendance and home exercise programme completion at two, six, and twelve weeks post-operatively. Compliance will be defined as attending at least 75 percent of scheduled sessions. Determinants to be assessed include transport access, perceived benefit, pain levels, educational level, family support, and financial ability to cover physiotherapy fees. Logistic regression will identify independent predictors of non-compliance. The study hypothesises that transport barriers and cost are the primary drivers of non-compliance. Findings will be submitted to the orthopaedic and physiotherapy departments at ESUTH to support the design of community-based rehabilitation alternatives and patient education materials. This research provides evidence to improve rehabilitation delivery models in South East Nigeria, contributing to better long-term orthopaedic outcomes for post-surgical patients in resource-limited settings. Keywords: physiotherapy compliance, post-operative rehabilitation, orthopaedic surgery, Enugu, patient adherence.