Document Detail


Physiotherapy after volar plating of wrist fractures is effective using a home exercise program.
MedLine Citation:
PMID:  19345766     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the effect of 2 different postoperative therapy approaches after operative stabilization of the wrist fractures: treatment by a physical therapist with 12 sessions and an unassisted home exercise program. DESIGN: Randomized controlled cohort study. SETTING: Hospital-based care, primary center of orthopedic surgery. PARTICIPANTS: Volunteers (N=48) with fractures of the distal radius after internal fixation with locking plates. There were 46 patients available for follow-up after exclusion of 2 participants due to physiotherapy sessions in excess of the study protocol. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Evaluation of grip strength using a Jamar dynamometer, range of motion (ROM), and Patient Related Wrist Evaluation (PRWE). RESULTS: After a 6-week period of postoperative treatment, the patients (n=23) performing an independent home exercise program using a training diary showed a significantly greater improvement of the functionality of the wrist. Grip strength reached 54% (P=.003), and ROM in extension and flexion 79% (P<.001) of the uninjured side. Ulnar and radial abduction was also higher in this group. In contrast, patients who were treated by a physical therapist achieved grip strength equal to 32%, and ROM in extension and flexion of 52% of the uninjured side. Patients who were performing the home training after operation recorded an improved wrist function with a nearly 50% lower value (P<.001) in the PRWE score. CONCLUSIONS: In the postoperative rehabilitation of wrist fractures, instructions in a home exercise program are an effective alternative to prescribed physical therapy treatment.
Authors:
Gert D Krischak; Anna Krasteva; Florian Schneider; Daniel Gulkin; Florian Gebhard; Michael Kramer
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  90     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-06     Completed Date:  2009-04-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  537-44     Citation Subset:  AIM; IM    
Affiliation:
Center of Surgery, Clinic for Traumatology, Hand, Plastic, and Reconstructive Surgery, University of Ulm, Ulm, Germany.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Adult
Aged
Bone Plates
Cohort Studies
Exercise Therapy / methods*
Female
Follow-Up Studies
Fracture Fixation, Internal
Hand / physiopathology
Hand Strength
Home Nursing / methods*
Humans
Male
Middle Aged
Radius Fractures / rehabilitation*,  surgery
Range of Motion, Articular*
Self Care / methods*
Wrist Joint / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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