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 .
No difference between two types of exercise after proximal phalangeal fracture fixation: a randomised trial.
QUESTION Are 6 weeks of synergistic wrist and finger exercises with the metacarpophalangeal joint constrained in an orthosis ( constrained exercises ) more effective than traditional finger exercises with the metacarpophalangeal joint unconstrained ( unconstrained exercises ) after open reduction and internal fixation of a proximal phalangeal fracture in terms of impairment , activity limitation and participation restriction at 6 and 12 weeks ? DESIGN R and omised , parallel-group trial with concealed allocation , intention-to-treat analysis and blinded outcome assessors . PARTICIPANTS Sixty-six participants within 1 week of open reduction and internal fixation of proximal phalangeal fractures . INTERVENTION The experimental group carried out 6 weeks of synergistic wrist and finger exercises with the metacarpophalangeal joint constrained , whilst the control group carried out finger exercises with the metacarpophalangeal joint unconstrained , as part of a comprehensive rehabilitation program . OUTCOME MEASURES The primary outcomes were : active proximal interphalangeal joint extension of the injured finger , total active range of motion , and strength . Secondary outcomes were : pain , difficulty with specific h and activity and difficulty with usual h and activity . A blinded assessor measured outcomes at Weeks 1 , 6 and 12 . RESULTS By Week 6 , there were no significant between-group differences in improvement for : active proximal interphalangeal joint extension ( MD 2 deg , 95 % CI -3 to 7 ) ; total active finger range of motion ( MD 0 deg , 95 % CI -21 to 22 ) ; strength ( MD -2 kg , 95 % CI -8 to 4 ) ; pain ( MD 1/50 , 95 % CI -3 to 5 ) ; difficulty with specific h and activity ( MD 2/60 , 95 % CI -3 to 8) ; or difficulty with usual h and activity ( MD 0/40 , 95 % CI -4 to 3 ) . By Week 12 , there were also no significant between-group differences in any outcome . CONCLUSIONS Constrained and unconstrained exercises has similar effects after open reduction and internal fixation of proximal phalangeal fracture . REGISTRATION Australian New Zeal and Clinical Trials Registry ( ACTRN12610000294055 )
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 .