Abstract:
We sought to investigate the effects of early manual therapy on functional outcomes in patients treated with volar plating of a distal radius fracture (DRF). This was a prospective, single-blinded, randomized controlled trial. Patients treated with volar plating of a DRF were randomly assigned to either Early Manual Therapy Group (EMTG, n=19) or Standard Physiotherapy Group (SPG, n=20). While SPG received standard physiotherapy, EMTG received standard physiotherapy plus Mulligan\'s Mobilization with Movement technique two sessions a week, through 12 weeks. Function, pain intensity, range of motion, grip strength and the level of disability were assessed using the Patient Rated Wrist Evaluation (PRWE), Visual Analog Scale (VAS), goniometer, hand dynamometer and Disabilities of Arm, Shoulder and Hand (DASH) Questionnaire, respectively. Measurements were made at 3, 6, and 12 weeks postoperatively. Of the 54-screened patients, 39 met the inclusion criteria and were randomized. In total, 32 patients (EMTG, n=15; SPG, n=17) were analyzed. EMTG had significantly better DASH score and wrist flexion at 12 weeks, less pain and better PRWE total score, wrist extension, ulnar/radial deviation, supination and grip strength at all time points. Moreover, wrist flexion increased more with the addition of early manual therapy than standard physiotherapy alone (26.50±13.19 versus 16.21±16.06). The addition of early manual therapy to standard physiotherapy may contribute to better functional outcomes and be more effective in increasing wrist flexion in patients treated with volar plating of a DRF.
摘要:
我们试图研究早期手动治疗对桡骨远端骨折(DRF)掌侧钢板治疗患者功能预后的影响。这是一个潜在的,单盲,随机对照试验。接受DRF掌侧钢板治疗的患者被随机分配到早期手动治疗组(EMTG,n=19)或标准物理治疗组(SPG,n=20)。虽然SPG接受了标准物理治疗,EMTG每周接受两次标准的物理治疗以及Mulligan的运动动员技术,通过12周。Function,疼痛强度,运动范围,使用患者额定腕部评估(PRWE)评估握力和残疾水平,视觉模拟量表(VAS),测角仪,手测力计和手臂残疾,肩和手(DASH)问卷,分别。在术后3、6和12周进行测量。在54名接受筛查的患者中,39例符合纳入标准并随机分组。总的来说,32名患者(EMTG,n=15;SPG,n=17)进行分析。EMTG在12周时有明显的DASH评分和腕关节屈曲,更少的疼痛和更好的PRWE总分,手腕延伸,尺骨/径向偏差,所有时间点的旋光和握力。此外,增加早期手法治疗后,腕关节屈曲增加的幅度大于单纯标准理疗(26.50±13.19vs.16.21±16.06).在标准物理治疗中增加早期手动治疗可能有助于更好的功能结果,并且在使用DRF掌侧钢板治疗的患者中更有效地增加腕关节屈曲。