None listed
Conditions
Brief summary
Wrist fractures are amongst the most common fractures suffered by elderly patients. There is limited data regarding grip strength of elderly patients who have suffered a distal radius fracture at the 2 and 6 week mark post injury. We performed a pilot study in the last year investigating grip strength in patients with distal radius fractures at 2 and 6 weeks post injury to determine whether they could drive. One major finding was that patients over the age of 60 who suffered a distal radius fracture had around 0-5kg of grip strength when measured at 2 and 6 weeks post injury. We also found that most patients were given a physiotherapy handout of range of motion exercises which they could perform. There was no strict guideline or recommendation of how often to perform the exercises and there were no grip strength exercises recommended. Grip strength in elderly patients has been noted to be a good indicator of function. Maintenance of function in the elderly patient is of great importance to a patient’s independence in mobility and activities of daily living. We hypothesize that a grip strength focused exercise program given to elderly patients with distal radius fractures will significantly improve patients’ grip strength and therefore function. This study would be of clinical significance to the elderly patient who suffers a wrist fracture. If we can improve a person’s grip strength and function, we may also improve their quality of life. Aim/Objective: To determine whether an exercise program will improve grip strength in elderly patients with distal radius fractures treated nonoperatively. Secondary objective 1. Determine whether an exercise program will improve pain in elderly patients with distal radius fractures 2. To determine whether an exercise program will improve function and reduce complex regional pain syndrome Hypothesis We hypothesize that adherence to a grip strength focused exercise program for a month between 2 weeks and 6 weeks post injury will improve grip strength in elderly patients who suffer a distal radius fracture.
Interventions
intervention:
A 4 week schedule of specific hand strength exercises to perform on a daily basis at home between 2 and 6 weeks after injury
Patients will tick off a check sheet regarding adherence to the exercises and this will be collected at the 6 week mark.
The exercises to be performed in the intervention group have been discussed with the supervisor who is a hand surgeon and the physiotherapist. It will consist of 3 categories; Finger range of motion, isometric finger exercises and the us
intervention: A 4 week schedule of specific hand strength exercises to perform on a daily basis at home between 2 and 6 weeks after injury Patients will tick off a check sheet regarding adherence to the exercises and this will be collected at the 6 week mark. The exercises to be performed in the intervention group have been discussed with the supervisor who is a hand surgeon and the physiotherapist. It will consist of 3 categories; Finger range of motion, isometric finger exercises and the use of a squeeze ball given to the patient. The finger range of motion exercises and isometric finger exercises will be performed in the 1st week with the use of the squeeze ball to be introduced in the 2nd week and consistently used in the 3rd and 4th week. In the intervention group, the exercises will be explained to the patient at their fracture clinic follow up on recruitment. The surgeon will explain to the participant the exercises in a 1 half hour session. Each exercise is explained to the patient clearly by the surgeon showing the patient with their own hand, and the participant then performing the exercise with their normal hand then their injured hand. The participant will then receive a 4 week schedule to follow explaining the exercises daily and a checklist to tick off to ensure that the participant is following the exercise program. If the participant has any questions after the visit during the 4 weeks, they are advised to contact the investigator or the surgeon for further explanation. There is no specific duration in which the participant must complete the exercises daily. They have a set regime i.e. finger isometric exercises each finger 10 times a day in which is advised to carry out within a day, but not within a time limit of that day. The intervention group will have a cast. The same as the control group. The short arm fibreglass cast will however have enough room to enable the participant to make a fist, and be able to touch each finger and thumb together, allowing free movement of the thenar eminence.
Sponsors
Dr Jai Sungaran
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
distal radius fracture in patients over the age of 60 single sided fracture
Exclusion criteria
bilateral distal radius fracture existing neurological condition which has lead to weakness in the ipsilateral limb prior distal radius fracture in same arm prior hand or wrist surgery in same arm patients with dementia or unable to follow instructions
Outcome results
None listed