There was preliminary evidence from one trial that exercise to the non-injured arm during immobilisation might lead to short-term benefits on increasing grip strength and range of movement following distal radius fracture .
There is emerging evidence that current prescribed exercise regimens may not be effective in reducing impairments and improving activity following an upper limb fracture .
Starting exercise early combined with a shorter immobilisation period is more effective than starting exercise after a longer immobilisation period .
QUESTION What is the effect of exercise on increasing participation and activity levels and reducing impairment in the rehabilitation of people with upper limb fractures ?
Bruder AM , Shields N , Dodd KJ , Taylor NF ( 2017 ) Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation : a systematic review .
Preventing functional loss during immobilization after osteoporotic wrist fractures in elderly patients: a randomized clinical trial
Background Distal radius fractures are among the most common fractures and account for approximately one-sixth of all fractures diagnosed . Therapy results after distal radius fracture , especially of elderly patients , are often suboptimal . The inevitable immobilization for several weeks leads to reduction in range of motion , deterioration of muscle strength , malfunction of fine motor skills as well as changes of motor and sensory representations in the brain . Currently , there are no strategies to counteract these immobilization problems . The overall aim of the study is to investigate the therapeutic potential of motor-cognitive approaches ( mental practice or mirror therapy ) on h and function after wrist fracture . Methods / Design This study is a controlled , r and omized , longitudinal intervention study with three intervention groups . One experimental group imagines movements of the fractured upper extremity without executing them ( mental practice ) . The second experimental group receives a mirror therapy program consisting of the performance of functional movement synergies using the unaffected forearm , wrist , and h and . The control group completes a relaxation training regime . Additionally , all patients receive usual care by the general practitioner . We include women aged 60 years and older having a distal radius fracture and sufficient cognitive function . All groups are visited at home for therapy sessions 5 times per week for the first 3 weeks and 3 times per week for weeks 4 to 6 . Measurements are taken at therapy onset , and after 3 , 6 and 12 weeks . The primary outcome measure will assess upper extremity functioning ( Patient-Rated Wrist Evaluation [ PRWE ] ) , while secondary outcome measures cover subjective wrist function ( Disabilities of the Arm and Shoulder ; [ DASH ] , objective impairment ( range of motion , grip force ) and quality of life ( EuroQol-5D , [ EQ5D ] ) . Discussion Results from this trial will contribute to the evidence on motor-cognitive approaches in the early therapy of distal radius fractures . Trial registration The trial is registered at Clinical Trials.gov with registration number NCT01394809 and was granted permission by the Medical Ethical Review Committee of the University of Tübingen in June 2011
There was preliminary evidence from one trial that exercise to the non-injured arm during immobilisation might lead to short-term benefits on increasing grip strength and range of movement following distal radius fracture .
There is emerging evidence that current prescribed exercise regimens may not be effective in reducing impairments and improving activity following an upper limb fracture .
Starting exercise early combined with a shorter immobilisation period is more effective than starting exercise after a longer immobilisation period .
QUESTION What is the effect of exercise on increasing participation and activity levels and reducing impairment in the rehabilitation of people with upper limb fractures ?
Bruder AM , Shields N , Dodd KJ , Taylor NF ( 2017 ) Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation : a systematic review .