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An advice and exercise program has some benefits over natural recovery after distal radius fracture: a randomised
Sandra Kay1, Margaret McMahon, Kathy Stiller
1Physiotherapy, Royal Adelaide Hospital, Adelaide, SA, 5000, Australia. sandra.kay@health.sa.gov.au
Question:
Does an advice and exercise program improve outcome for adults following distal radius fracture?
Design:
Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis.
Participants:
Fifty-six patients whose fracture had been managed with pins and/or cast.
Intervention:
The experimental group received a physiotherapist-directed program of advice and exercises. The control group did not receive any physiotherapy intervention.
Outcome Measures:
The primary outcome was wrist extension (measured with a goniometer). Secondary outcomes were the other wrist ranges of motion (measured with a goniometer), grip strength (measured with a dynamometer), pain, and activity limitations (measured with questionnaires). These outcomes were measured initially, then three and six weeks later. Participants also rated their satisfaction with physiotherapy intervention at Week 6.
Results:
No difference was found between groups for the primary outcome of wrist extension (mean difference 6 deg, 95% CI -3 to 14), nor for the secondary outcomes of other range of motion data and grip strength. The difference between groups for pain was -16 points out of 100 (95% CI -27 to -5) at Week 3, and -14 points (95% CI -25 to -3) points at Week 6, and for activity was -13 points out of 100 (95% CI -24 to -2) at Week 3; in favour of the experimental group. The experimental group was also more satisfied with the amount of physiotherapy intervention.
Conclusion:
An advice and exercise program provided some additional benefits over no intervention for adults following distal radius fracture.
