Efficacy of combined physical and occupational therapy in patients with conservatively treated distal radius...

To evaluate the efficacy of combined physical and occupational therapy in comparison with physical therapy alone in patients with conservatively treated distal radius fracture.

Sixty-one participants, conservatively treated after a distal radius fracture, were included in a randomized and single-blind trial. Group A had physical therapy only (n = 31) and group B had physical and occupational therapy (n = 30). The assessment was performed three times: upon inclusion in the study in the first week after removal of the cast (T1), immediately after the end of the rehabilitation (T2), and 1 month after completing the rehabilitation (T3). The passive wrist range-of-motion, grip strength, and Disabilities of Arm, Shoulder and Hand (DASH) score were used as rehabilitation outcomes.

Rehabilitation outcomes were analyzed using two-way mixed analysis of variance. The effect of time was statistically significant (p < 0.001) for all outcomes. The group (therapy) factor was statistically significant for grip strength only (p = 0.038). The interaction effect was statistically significant for rotation (p = 0.034) and grip strength (p = 0.021). A comparison between time points T3:T1 showed statistically significant difference in grip strength in favor of group B 67 % (95 % CI 60-74 %) versus group A 53 % (95 % CI 45-61 %), p = 0.024.

The combined therapy resulted in a statistically significant increase of grip strength in comparison with isolated physical therapy in the period of 12-16 weeks after the fracture. This effectiveness was not confirmed with DASH score results.