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Traditional Versus Digital Media–Based Hand Therapy After Distal Radius Fracture

Published:August 05, 2021DOI:https://doi.org/10.1016/j.jhsa.2021.06.018

      Purpose

      Distal radius fractures (DRFs) are common injuries with a rising incidence. A substantial portion of the cost of care is attributable to therapy services. Our purpose was to evaluate the effectiveness of a self-directed hand therapy program guided by digital media compared with that of traditional therapy.

      Methods

      We conducted a randomized controlled trial in patients aged 18 years or older who underwent open reduction and internal fixation of a DRF with volar plating. Subjects were randomized to traditional hand therapy using a 12-week protocol or an identical protocol presented in digital videos and performed at home. Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores were collected as the primary outcome at 2 weeks (baseline), 6 weeks, and 12 weeks or greater. Pain visual analog scale (VAS) scores, Veterans RAND 12-Item Health Survey (VR-12) scores, wrist and forearm range of motion, wrist circumference, and grip strength were recorded as secondary outcomes.

      Results

      Fifty-one patients were enrolled. Forty-nine patients were included in the analysis—21 in the digital media group and 28 in the traditional group. Both groups demonstrated significant improvements in QuickDASH scores between baseline and 12-week or greater time points. The QuickDASH scores in the digital media group were slightly more improved than those in the traditional group at the 6-week and 12-week or greater time points; however, these differences were not statistically significant. Pain VAS and VR-12 scores were comparable between group differences at each time point.

      Conclusions

      Our digital media program was at least as effective as traditional therapy for patients undergoing volar plating of DRF. These results may help inform the design of future trials investigating the effectiveness of digital media–based hand therapy programs.

      Type of study/level of evidence

      Therapeutic II.

      Key words

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      Linked Article

      • Erratum
        Journal of Hand SurgeryVol. 47Issue 10
        • Preview
          In the article by Lara et al in the March 2022 issue of The Journal of Hand Surgery (“Traditional Versus Digital Media—Based Hand Therapy After Distal Radius Fracture”, Vol. 47, No. 3, p. 291.e1-291.e8), some of the values and units for grip strength in Table 3 were incorrect. Please see the following corrected table. The publisher and authors regret this error.
        • Full-Text
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      • Second Letter Regarding “Traditional Versus Digital Media—Based Hand Therapy After Distal Radius Fracture”
        Journal of Hand SurgeryVol. 47Issue 3
        • Preview
          I would like to raise 2 concerns in response to the article by Lara et al1 on hand therapy following distal radius fracture. First, the therapist-led intervention lacked external validity, given that it did not accurately portray how therapy is individualized (ie, based on health literacy, severity of injury, etc) and addresses more than body structure impairment. I raise this point because it is likely that the hand therapists who communicated these exercises to the study participants were occupational therapists,2 and our approach toward improving function is top-down, supporting participation in daily life and reducing the barriers contributing to limitations.
        • Full-Text
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