Effekt eines Heimtrainingsprogramms in der Nachbehandlung konservativ behandelter distaler Radiusfrakturen – eine prospektiv randomisierte Studie

PURPOSE: Rehabilitation is an integral part of the concept for wrist fractures treated through immobilization. Our aim was to determine the effect of two different therapy concepts on the outcome in a prospective study: treatment by a professional physical therapist and an unassisted home exercise program. MATERIALS AND METHODS: 42 volunteers with conservatively treated wrist fractures were randomized in treatment by a professional physical therapist (n=21) with 12 sessions, and an unassisted home exercise program (n=21). Follow-up six weeks later involved evaluation of range of motion, grip strength using a Jamar dynamometer, and the functional score Patient Related Wrist Evaluation (PRWE). RESULTS: After a six week period of post-operative treatment, the patients performing a self-dependant home exercise program using a training diary reached significantly higher grip strength (83% vs. 67% of the starting base value; p=0.0203). There were no differences in the range of motion of pronation/supination, extension and flexion, or ulnar and radial abduction. However, self training patients showed a significantly greater improvement of the functionality of the wrists according to PRWE score (8.4 vs. 22.5; p=0.0029). DISCUSSION: The effectiveness of a home exercise program requires motivated patients being self-responsible and independent in performing rehabilitation at home. The decision of treating patients self-responsibly has to be considered critically with the patient. CONCLUSIONS: In the rehabilitation of conservatively treated wrist fractures, good functional results can be reached using instructions in a home exercise program, and are an effective alternative to prescribed rehabilitation treatment.