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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Article info
Publication history
Published online: August 05, 2021
Accepted:
June 23,
2021
Received:
April 29,
2020
Footnotes
Dr Mirarchi is a paid consultant for Acumed and Smith and Nephew and receives publishing royalties from Wolters Kluwer Health - Lippincott Williams & Wilkins. Dr Kagan receives research support from Kinetic Concepts, Inc. No benefits in any form have been received or will be received by the other authors related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
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- ErratumJournal of Hand SurgeryVol. 47Issue 10
- PreviewIn 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.
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- Second Letter Regarding “Traditional Versus Digital Media—Based Hand Therapy After Distal Radius Fracture”Journal of Hand SurgeryVol. 47Issue 3
- PreviewI 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.
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