hrvatski

Effects of kinesiotherapy after conservative treatment of distal radius fracture: home-based vs supervised physical therapy protocol

Principal objective of this study was kinesiotherapy importance assessment after conservative treatment of fractures of the distal part of radius. The study included comparison of home-based exercises with supervised kinesiotherapy protocol to examine which would give better results in restoring normal function of the hand. The study included 40 patients, aged between 37 and 85. A total of 29 patients reported injuries in their left hand and 11 patients complained about their right hand, 16 patients had intra-articular distal radius fractures while 24 patients had extra-articular distal radius fractures. Radiological confirmation of fracture reposition was followed by immobilization with forearm plaster splint and with wrist in mild palmar flexion and ulnar deviation. Four weeks later, the immobilization was discharged and patients were divided into two groups: Group 1- home kinesiotherapeutical programme (HK) and Group 2- control group including patients who attended on a supervised physical therapy (SK). After the removal of the immobilization in all patients from both groups, range of motion (ROM) testing was done and all patients completed the questionnaire Patient-Rated Wrist Evaluation (PRWE) and underwent radiographic measurements. Due to identification of significance of differences between groups and within repeated measurements 2-way mixed design ANOVA was applied. From the perspective of the overall sample, the patients had significantly higher PRWE before rehabilitation in relation to the time period after rehabilitation (F[1.38]=202.931, P<0.001). Mean PRWE for HK group, taking the average of the two measurements was 48.442±3.527 points, and thus it was not significantly lower than in SK group (57.982±4.806 points) (F[1.38]=2.561, P=0.118). No difference was registered in ROM between the two groups, while ROM was significantly improved in both groups after the period of rehabilitation. The same results were obtained for radiological parameters as well. Results of this study show there was no significant difference between clinical and radiological parameters among the patients from both groups. Results are clearly pointing to the fact that HK is the cost-effective method of choice in the rehabilitation of patients after conservative treatment of distal radius fractures which provides results equal to standard physical treatment.

ROM, Patient-Rated Wrist Evaluation, radiographic measurements

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