An advice and exercise program has some benefits over natural recovery after distal radius fracture: a randomised trial.

QUESTION Does an advice and exercise program improve outcome for adults following distal radius fracture? DESIGN Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis. PARTICIPANTS Fifty-six patients whose fracture had been managed with pins and/or cast. INTERVENTION The experimental group received a physiotherapist-directed program of advice and exercises. The control group did not receive any physiotherapy intervention. OUTCOME MEASURES The primary outcome was wrist extension (measured with a goniometer). Secondary outcomes were the other wrist ranges of motion (measured with a goniometer), grip strength (measured with a dynamometer), pain, and activity limitations (measured with questionnaires). These outcomes were measured initially, then three and six weeks later. Participants also rated their satisfaction with physiotherapy intervention at Week 6. RESULTS No difference was found between groups for the primary outcome of wrist extension (mean difference 6 deg, 95% CI -3 to 14), nor for the secondary outcomes of other range of motion data and grip strength. The difference between groups for pain was -16 points out of 100 (95% CI -27 to -5) at Week 3, and -14 points (95% CI -25 to -3) points at Week 6, and for activity was -13 points out of 100 (95% CI -24 to -2) at Week 3; in favour of the experimental group. The experimental group was also more satisfied with the amount of physiotherapy intervention. CONCLUSION An advice and exercise program provided some additional benefits over no intervention for adults following distal radius fracture.