Duration of superficial heat modality on wrist and finger range of motion: A quasi-experimental study

There is a lack of studies on the optimal duration and carry-over effect of superficial heat treatment to increase joint range of motion.This study aims to determine the optimal treatment duration of Fluidotherapy® and Hot Pack in improving wrist and finger active range of motion (AROM) and investigate possible carry-over effects.

The study used a single-site, multi-arm quasi-experimental design. Participants aged 21-80 years with distal radius fracture or fracture and/or soft tissue injuries involving the finger or thumb were assigned consecutively to one of six groups of 10, 15 or 20 min Fluidotherapy® or Hot Pack treatment.All participants had goniometric assessment of their wrist or finger joint AROM adjacent to the injury site and were asked to rate the joint flexibility: (i) prior to treatment; (ii) immediately after treatment; and (iii) after 20 min of AROM mobilisation post-heat treatment. Subjects were asked to rate their joint flexibility again 2 h after the study visit, via telephone. Results were analysed using the Kruskal-Wallis test of association with significance P < 0.05.

Participants who had 10 and 20 min Fluidotherapy® and 10 and 15 min Hot Pack treatment showed significant wrist flexion and extension AROM increase immediately after treatment. Participants who had 15 and 20 min Fluidotherapy®, and 15 and 20 min Hot Pack treatment showed further increase in wrist AROM after 20 min of mobilization. Participants with finger injuries in all the treatment groups showed no significant changes in MCPJ or PIPJ AROM immediately and 20 min after treatment.Participants in all treatment groups reported significantly increased wrist flexibility while participants who had 15 min Fluidotherapy® and 20 min Hot pack reported significantly increased MCPJ or PIPJ flexibility, compared to baseline, immediately, 20 min and 2 h after treatment.

Although there were significant improvements in wrist extension and flexion AROM after 10 or 20 min of Fluidotherapy® and after 10 or 15 min of Hot Pack application, the improvement may not be considered clinically significant. Participants report of significantly improved wrist flexibility in all treatment groups and increased MCPJ and DIPJ flexibility in 2 groups immediately, 20 min, and 2 h after treatments demonstrated the potential of these 2 modalities as pain management adjuncts for pre-conditioning prior to mobilisation.