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The effectiveness of adding a scapular exercise programme to physical therapy treatment in patients with distal radius fracture treated conservatively: a randomized controlled trial [with consumer summary]
Gutierrez-Espinoza H, Araya-Quintanilla F, Gutierrez-Monclus R, Cavero-Redondo I, Alvarez-Bueno C
Clinical Rehabilitation 2019 Dec;33(12):1931-1939
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To determine the effectiveness of a scapular exercise programme in addition to a physical therapy treatment in patients with distal radius fracture. DESIGN: A single-blinded randomized controlled trial was conducted. SETTING: Clinical Hospital San Borja Arriaran, Santiago, Chile. PARTICIPANTS: A total of 102 patients above 60 years of age with extra-articular distal radius fracture were randomly divided into two groups. INTERVENTIONS: The control group (n = 51) received a six-week physical therapy treatment; the intervention group (n = 51) received the same treatment plus a scapular exercise programme. OUTCOME MEASURES: The two groups were assessed at baseline and after the six-week treatment. The arm function was assessed with the disabilities of the arm, shoulder and hand (DASH) questionnaire; secondary outcomes were measured by the patient-rated wrist evaluation (PRWE) questionnaire and visual analogue scale (VAS). RESULTS: A total of 102 patients, 51 in the control group (40 women; mean age of 65.3 +/- 4.8 years) and 51 in the intervention group (42 women; mean age of 67.2 +/- 5.4 years), were analysed. At the end of the treatment, the difference between groups for the DASH was 16.7 points (p < 0.001), 1.5 points (p = 0.541) for the PRWE, 0.2 cm (p = 0.484) for the VAS at rest, and 1.7 cm (p < 0.001) for the VAS at movement. All differences were in favour of the intervention group. CONCLUSION: In the short term, adding a scapular exercise programme provides a significant clinical benefit in arm function and pain relief with movement in patients above 60 years of age with extra-articular distal radius fracture treated conservatively.

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