Article

OBJECTIVE: To evaluate the effects of cross-education (contralateral effect of
unilateral strength training) during recovery from unilateral distal radius
fractures on muscle strength, range of motion (ROM),
and function. DESIGN:
Randomized controlled trial
(26-wk follow-up).
SETTING: Hospital, orthopedic
fracture clinic. PARTICIPANTS: Women older than 50 years with a unilateral distal
radius fracture. Fifty-one participants were randomized and 39 participants were
included in the final data analysis. INTERVENTIONS: Participants were randomized
to standard rehabilitation (Control) or standard rehabilitation plus strength
training (Train). Standard rehabilitation included forearm casting for 40.4+/-6.2
days and hand exercises for the fractured extremity. Nonfractured hand strength
training for the training group began immediately postfracture and was conducted
at home 3 times/week for 26 weeks. MAIN OUTCOME MEASURES: The primary outcome
measure was peak force (handgrip dynamometer). Secondary outcomes were ROM
(flexion/extension; supination/pronation) via goniometer and the Patient Rated
Wrist Evaluation questionnaire score for the fractured arm. RESULTS: For the
fractured hand, the training group (17.3+/-7.4kg) was significantly stronger than
the control group (11.8+/-5.8kg) at 12 weeks postfracture (P<.017). There were no
significant strength differences between the training and control groups at 9
(12.5+/-8.2kg; 11.3+/-6.9kg) or 26 weeks (23.0+/-7.6kg; 19.6+/-5.5kg)
postfracture, respectively. Fractured hand ROM showed that the training group had
significantly improved wrist flexion/extension (100.5 degrees +/-19.2 degrees )
than the control group (80.2 degrees +/-18.7 degrees ) at 12 weeks postfracture
(P<.017). There were no significant differences between the training and control
groups for flexion/extension ROM at 9 (78.0 degrees +/-20.7 degrees ; 81.7
degrees +/-25.7 degrees ) or 26 weeks (104.4 degrees +/-15.5 degrees ; 106.0
degrees +/-26.5 degrees ) or supination/pronation ROM at 9 (153.9 degrees +/-23.9
degrees ; 151.8 degrees +/-33.0 degrees ), 12 (170.9 degrees +/-9.3 degrees ;
156.7 degrees +/-20.8 degrees ) or 26 weeks (169.4 degrees +/-11.9 degrees ;
162.8 degrees +/-18.1 degrees ), respectively. There were no significant
differences in Patient Rated Wrist Evaluation questionnaire scores between the
training and control groups at 9 (54.2+/-39.0; 65.2+/-28.9), 12 (36.4+/-37.2;
46.2+/-35.3), or 26 weeks (23.6+/-25.6; 19.4+/-16.5), respectively. CONCLUSIONS:
Strength training for the nonfractured limb after a distal radius fracture was
associated with improved strength and ROM in the fractured limb at 12 weeks
postfracture. These results have important implications for rehabilitation strategies after unilateral injuries.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS