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 .
Accelerated rehabilitation compared with a standard protocol after distal radial fractures treated with volar open reduction and internal fixation: a prospective, randomized, controlled study.
BACKGROUND There are relatively few studies in the literature that specifically evaluate accelerated rehabilitation protocol s for distal radial fractures treated with open reduction and internal fixation ( ORIF ) . The purpose of this study was to compare the early postoperative outcomes ( at zero to twelve weeks postoperatively ) of patients enrolled in an accelerated rehabilitation protocol  with those of patients enrolled in a st and ard rehabilitation protocol following ORIF for a distal radial fracture . We hypothesized that patients with accelerated rehabilitation after volar ORIF for a distal radial fracture would have an earlier return to function compared with patients who followed a st and ard protocol .  METHODS From November 2007 to November 2010 , eighty-one patients with an unstable distal radial fracture were prospect ively r and omized to follow either an accelerated or a st and ard rehabilitation protocol after undergoing ORIF with a volar plate for a distal radial fracture . Both groups began with gentle active range of motion at three to five days postoperatively . At two weeks , the accelerated group initiated wrist/forearm passive range of motion and strengthening exercises , whereas the st and ard group initiated passive range of motion and strengthening at six weeks postoperatively . Patients were assessed at three to five days , two weeks , three weeks , four weeks , six weeks , eight weeks , twelve weeks , and six months postoperatively . Outcomes included Disabilities of the Arm , Shoulder and H and ( DASH ) scores ( primary outcome ) and measurements of wrist flexion/extension , supination , pronation , grip strength , and palmar pinch . RESULTS The patients in the accelerated group had better mobility , strength , and DASH scores at the early postoperative time points ( zero to eight weeks postoperatively ) compared with the patients in the st and ard rehabilitation group . The difference between the groups was both clinical ly relevant and statistically significant . CONCLUSIONS Patients who follow an accelerated rehabilitation protocol that emphasizes motion immediately postoperatively and initiates strengthening at two weeks after volar ORIF of a distal radial fracture have an earlier return to function than patients who follow a more st and ard rehabilitation protocol . LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence
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 .