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| Does a hand strength focused exercise program improve grip strength in older patients with wrist fractures managed non-operatively? A randomized controlled trial |
| Nguyen A, Vather M, Bal G, Meaney D, White M, Kwa M, Sungaran J |
| American Journal of Physical Medicine & Rehabilitation 2020 Apr;99(4):285-290 |
| clinical trial |
| 6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; 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* |
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OBJECTIVE: Distal radius fractures in the older population significantly impairs grip strength. This study aimed to investigate whether a hand strength focused exercise program during the period of immobilization for non-operatively managed distal radius fractures in this population improved grip strength and quality of life. DESIGN: Single centre randomized controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. Fifty-two patients, age > 60 who suffered distal radius fractures managed non-operatively with cast immobilization. The intervention group (n = 26) received a home hand strength focused exercise program from 2 to 6 weeks after injury whilst immobilized in a full short arm cast. The control group (n = 26) performed finger range of motion exercises as per protocol. Primary outcome was grip strength ratio (GSR) of injured arm compared to uninjured arm. Secondary outcome included functional score of QuickDASH. Outcomes were measured at 2, 6 and 12 weeks after injury. RESULTS: The intervention group significantly improved GSR at both 6 and 12 weeks (6 weeks 40% versus 25% (p = 0.0044) and 12 weeks 81% versus 51% (p = 0.0035)). The intervention group improved the QuickDASH score at 12 weeks however this was not statistically significant (25 versus 40 p = 0.066). CONCLUSION: A hand strength focused exercise program for elderly patients with distal radius fractures whilst immobilized significantly improved grip strength.
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