Combined home and clinic-based therapy versus home-based exercise programme after distal radial fracture: a...

Area of Science:

• Orthopedics
• Physical Therapy
• Rehabilitation Medicine

Background:

• Distal radius fractures are common, often treated with anterior plating.
• Post-operative rehabilitation is crucial for restoring function.
• The optimal balance between home-based and clinic-based therapy is not fully established.

Purpose of the Study:

• To compare the effectiveness of home-based exercise programs alone versus combined with varying numbers of clinic-based hand therapy sessions after anterior plating for distal radius fractures.
• To evaluate the impact of different therapy intensities on patient-reported outcomes and grip strength.

Main Methods:

• A randomized controlled trial involving 102 patients with distal radius fractures treated with anterior plating.
• Patients were assigned to three groups: home exercises alone, home exercises with 4 clinic sessions, or home exercises with 7 clinic sessions.
• Outcomes assessed included Patient-Rated Wrist Evaluation scores and grip strength at 6 and 12 weeks post-surgery.

Main Results:

• Patients receiving 7 clinic sessions showed significantly better Patient-Rated Wrist Evaluation scores at 6 weeks compared to home exercises alone (12 vs. 30).
• This significant difference in patient-reported outcomes diminished by 12 weeks.
• Grip strength was significantly improved at both 6 and 12 weeks in the groups with clinic-based therapy compared to home exercises alone.

Conclusions:

• Combining clinic-based hand therapy with home exercises may accelerate functional recovery after anterior plating for distal radius fractures.
• A higher number of clinic sessions (7) demonstrated early benefits in patient-reported wrist function.
• Integrated therapy approaches appear beneficial for optimizing rehabilitation outcomes in this patient population.