Comparison of Occupational Therapy and Home Exercises for Adults With Operatively Treated Distal Radius Fractures

Mass General Brigham

Status: Completed

Conditions: Distal Radius Fractures

Treatments: Other: Occupational Therapy; Other: Independent Excercises

Study type: Interventional

Funder types: Other

Identifiers

NCT00438750

2006-P-001157

Details and patient eligibility

About

The purpose of this study is to compare to ways of rehabilitating after surgery for distal radius fractures treated operatively with a volar plate.

Full description

Operative treatment of distal radius fractures has become commonplace over the last three decades as our understanding of the relationship between the alignment of the distal radius and the function of the wrist and forearm has improved. Over the last 15 years there has been a trend towards more invasive, internal plate fixation of fractures of the distal radius. One argument in favor of internal fixation for these fractures is that it would be beneficial to allow early movement of the wrist articulation in an attempt to maximize final outcome. There is a difference in opinion among physicians on the importance of supervision of exercises in the recovery process. Some physicians advocate formal occupational therapy while other physicians believe that appropriate instructions for home exercises are just as good. A common belief is that the motivation of the patient plays an important part in recovery. In addition, Psychological and personality factors, such as pain anxiety, catastrophizing, and depression are strongly related to upper extremity specific health status and may also influence recovery. The goal of this study is to determine which protocol for exercises leads to better outcome in patients treated for distal radius with a volar plate. As a secondary goal and to generate hypotheses for later studies we would like to evaluate the influence of psychosocial factors on both objective (motion, grip strength) and subjective (DASH questionnaire) measures of functional recovery.

Enrollment: 94 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18 or greater.
• Isolated distal radial fracture.
• Fracture treated with volar plates, stable fixation.
• Initial treatment within 4 weeks of trauma.

Exclusion criteria

• Complex fractures that require additional or different material than volar plates.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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94 participants in 2 patient groups

Independent Home Exercises

Experimental group

Description:

Subjects who learn their therapy exercises from the surgeon and practice them independently at home.

Treatment:

Other: Independent Excercises

Formal Therapy

Experimental group

Description:

Subjects who follow the conventional protocol of seeing a therapist to learn and guide them in their exercises.

Treatment:

Other: Occupational Therapy