Graduation Date

Spring 5-6-2023

Document Type


Degree Name

Master of Science (MS)


Medical Anatomy

First Advisor

Dr. Zachary M Bauman

Second Advisor

Dr. Samantha M Simet

Third Advisor

Dr. Travis McCumber

Fourth Advisor

Dr. Crystal Krause


Rib fractures are the most common injury in patients who sustain trauma to the chest wall. These patients often report exacerbated pain severity with deep breathing, coughing, and performing movements of the upper body. Clinical experience in treating these patients shows that patients usually avoid movement due to increased pain severity. Most pain scores from patients with chest wall injuries are assessed while the patient lies comfortably in bed. Although pain is the primary complaint of patients with chest wall injury, the assessment of this pain is likely under-represented, given that these patients remain inactive due to the pain that movement induces. Our aim in this pilot study was to test our hypothesis that chest wall movement influences patient pain scores in patients with rib fractures. We used the 11-point numeric rating scale to assess pain severity in inpatients with one or more rib fractures during index hospitalization. Patients were asked to rate their pain severity verbally while performing a series of movements in the following order: at rest, using an incentive spirometer, performing flexion, extension, lateral flexion, and rotation of the trunk, and holding a 5-pound dumbbell. Additionally, patients were asked if they experienced any clicking or popping of ribs. This study’s findings will help future studies evaluate the effectiveness of treatment interventions in chest wall injury patients, especially in patients without flail chest. Improvements in evidence-based pain management practices will lead to an overall improvement in the quality of life for these individuals.


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Available for download on Sunday, April 27, 2025

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