A long term effect of distal radius fracture on the sensorimotor control of the wrist joint in older adults.

Abstract Study design This study is a cross-sectional case-control study. Introduction Sensorimotor control can be disturbed in musculoskeletal disorders due to multiple causes including pain and trauma. There is scarce comprehension about which component of the sensorimotor system would benefit the most from treatment in distal radius fracture (DRF). Purpose of the study: Is the sensorimotor control of subjects with a history of DRF impaired compared to healthy subjects? If so, which component of the sensorimotor system is most affected? Methods Nine healthy participants and eleven participants with a DRF history executed posture and reproduction tasks in interaction with a robotic wrist manipulator. A posture task with force perturbations assessed sensorimotor control. Position and force reproduction tasks assessed sensory feedback. Electromyography recorded the muscle activity to study the motor part of the sensorimotor system. Results Results showed that the motor responses to the perturbations during the posture task did not differ significantly, while the position reproduction did significantly differ between the two groups. Moreover, participants with a DRF history did not adapt to the changed dynamics of the environment during the posture task while controls did. Discussion The results of this study imply that processing of sensory position feedback is impaired in people with a DRF history while sensorimotor control during a posture task is unaffected. A possible explanation for these results is that different neural networks are involved during reproduction and posture tasks. Conclusions A history of DRF is related to disturbed processing of sensory feedback of the sensorimotor system, especially the Joint Position Sense (JPS), which leads to an impairment in detecting a changed environment and adapting to it. Impaired JPS and thereby the inability to adapt adequately to a changing environment should be taken into account during the rehabilitation of patients with DRF. Level of evidence The level of evidence is III (according to the classification of Sackett).