Effectiveness of Graded Motor Imagery to Improve Hand Function in Patients With Distal Radius Fracture

Study Overview
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Brief Summary
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The purpose of this study was to investigate of the effectiveness of Graded Motor Imagery (GMI) on hand functionality in patients with Distal Radius Fracture (DRFx). This study was carried out on 36 patients. These patients were randomly assigned to two groups: classic treatment group (n=19) and GMI group (n=17). Both groups received a 8-week (2 days a week) physical therapy and rehabilitation intervention. Outcome measurements were based on upper extremity functional status (Disability of the Arm Shoulder Hand and Michigan Hand Questionnaire scores), pain (on the rest and during the activity with Visual Analog Scale), range of motion (wrist flexion, extension, ulnar/radial deviation, supination and pronation with goniometer), grip strength (standard grip strength with Jamar hydraulic hand dynamometer; lateral, palmar and pinch strength with pinch meter).

Official Title
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Cognitive Therapy Model: Graded Motor Imagery

Conditions
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Distal Radius Fracture, Pain

Intervention / Treatment
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* Procedure: Cognitive Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ages between 18-65 years diagnosed with DRFx which is extra-articular managed with pins, internal fixation and/or cast Exclusion Criteria: unwilling or unable to participate intra-articular and instable fractures containing other part of the fractures fractures related with the malignancy and other neurologic diseases existing inflammatory joint condition, lack of cognitive function.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cognitive Therapy<br>Graded motor imagery program was applied in only intervention group for 8 weeks. | Procedure: Cognitive Therapy<br>* Graded Motor Imagery has three stages: Lateralisation (2 or 3 weeks) Motor Imagery (2 or 3 weeks) Mirror Therapy (2 or 3 weeks)<br>* Other names: Rehabilitation;|
| Active Comparator: Control<br>Rehabilitation program applied in both groups for 8 weeks. Frequency of the treatment was 2 days in per week and its duration was approximately one hour in one session. | Procedure: Cognitive Therapy<br>* Graded Motor Imagery has three stages: Lateralisation (2 or 3 weeks) Motor Imagery (2 or 3 weeks) Mirror Therapy (2 or 3 weeks)<br>* Other names: Rehabilitation;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical Function and Symptoms | Disability of the Arm, Shoulder and Hand (DASH) questionnaire scores range from 0 to 100 with a higher score indicating higher degree of disability. | 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity | Visual Analog Scale (VAS) is used to evaluate pain intensity. The scale was consisted of a standard line labeled 0 on the left and 10 on the right. (0: no pain, 10: the worst pain). | 8 weeks | 
| Normal range of motion | Active range of motions of wrist regarding flexion, extension, ulnar deviation, radial deviation, supination and pronation were evaluated with universal goniometer and recorded as degree. | 8 weeks | 
| Grip Strength | Grip strength was measured in kilograms using a calibrated Jamar Hydraulic Hand Dynamometer with the elbow flexed to 90 degree. | 8 weeks |