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 .
Therapist-supervised hand therapy versus home therapy with therapist instruction following distal radius fracture.
PURPOSE To investigate whether there was a difference in Patient-Rated Wrist H and Evaluation ( PRWHE ) scores between patients with and without comorbidities who receive regular supervised therapy provided by a certified h and therapist ( CHT )  compared with patients who were provided with a home exercise program  and were regularly monitored . METHODS Fifty patients with a diagnosis of distal radius fractures and volar plate fixation were enrolled in a prospect i ve , r and omized clinical trial comparing those who received therapy under the supervision of a CHT with those enrolled in a home exercise program that was instructed and monitored by a CHT . The primary outcome measure ( PRWHE ) and secondary outcome measures , total arc of motion for wrist flexion and extension , supination and pronation , and grip strength , were assessed at 12 weeks . The primary outcome measure for both groups was also gathered at 6 months . RESULTS There were no statistically significant differences between the final scores of the PRWHE , wrist or forearm motion , pain , or grip strength between groups . Effect size calculations revealed that both groups experienced a large effect size for all outcomes . CONCLUSIONS Supervised clinic-based therapy is equally beneficial for patients without complications . Clinic-based therapy may be preferable for patients with noteworthy complications after a distal radius fracture with volar plate fixation . Patients with decreased finger motion and various comorbidities may benefit from therapy provided in a clinic under the supervision of a certified h and therapist . TYPE OF STUDY /LEVEL OF EVIDENCE Therapeutic II
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 .