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Orthopädie 18. Jänner 2016

Efficacy of combined physical and occupational therapy in patients with conservatively treated distal radius fracture: randomized controlled trial

Aim: To evaluate the efficacy of combined physical and occupational therapy in comparison with physical therapy alone in patients with conservatively treated distal radius fracture.

Methods: Sixty-one participants, conservatively treated after a distal radius fracture, were included in a randomized and single-blind trial. Group A had physical therapy only (n = 31) and group B had physical and occupational therapy (n = 30). The assessment was performed three times: upon inclusion in the study in the first week after removal of the cast (T1), immediately after the end of the rehabilitation (T2), and 1 month after completing the rehabilitation (T3). The passive wrist range-of-motion, grip strength, and Disabilities of Arm, Shoulder and Hand (DASH) score were used as rehabilitation outcomes.

Results: Rehabilitation outcomes were analyzed using two-way mixed analysis of variance. The effect of time was statistically significant (p < 0.001) for all outcomes. The group (therapy) factor was statistically significant for grip strength only (p = 0.038). The interaction effect was statistically significant for rotation (p = 0.034) and grip strength (p = 0.021). A comparison between time points T3:T1 showed statistically significant difference in grip strength in favor of group B 67 % (95 % CI 60–74 %) versus group A 53 % (95 % CI 45–61 %), p = 0.024.

Conclusion: The combined therapy resulted in a statistically significant increase of grip strength in comparison with isolated physical therapy in the period of 12–16 weeks after the fracture. This effectiveness was not confirmed with DASH score results.

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