Introduction: Distal Radius Fracture is one of the most common fractures in forearm. Chronic pain after these fractures could affect as much as 30% of patients. 22 to 39% incidence of Complex Regional pain Syndrome (CRPS) has been reported in patients with distal radius fractures. Spinal PA mobilization has generalized sympathoexcitatory effects, stimulate pain inhibitory descending pathways from Periaqueductal grey of brain and produce immediate hypoalgesia.
Purpose: To see the effect of cervicothoracic mobilisation on pain, swelling and function over conventional therapy or control in these patients after plaster removal.
Design: Experimental randomized controlled study
Methodology: A total of 30 subjects (males-16,females-14) between the age group of 35 to 60 years with conservatively managed distal radius fractures meeting the inclusion and exclusion criteria were randomly divided into 3 groups.
• GROUP A (experimental) - 10 subjects received central PA mobilization of C7 to T3 spinous processes and conventional therapy including contrast bath and active and passive exercise.
• GROUP B (conventional) - 10 subjects received conventional therapy only.
• GROUP C (control) - 10 subjects received no treatment in first week followed by home exercise (auto assisted active exercises) in the second week.
Treatment was given daily 5 days a week for 2 weeks.
Data collection: Measurements grip strength using dynamometer, swelling using volumeter, patient rated wrist evaluation scale, wrist ROM using goniometer and Heart rate were taken prior to the beginning of treatment (Pretest) and were repeated after completion of first week (Post 1). Final measurements were taken on completion of second week (Post 2)
Data analysis: The dependent variables were analysed using 3 X 3 ANOVA with repeated measures of the second factor. All pair wise post hoc comparisons were done using a 0.05 level of significance.
Results: At the end of 1st week as well as 2nd week both experimental and conventional groups showed significantly better improvements in all the variables than control group. Experimental group was better than conventional group in all variables.
Conclusion: This study showed that conventional physiotherapy has a role in the rehabilitation of patients with distal radius fracture after plaster removal in reducing swelling, pain and improving range of motion, strength and earlier return of function. However cervicothoracic mobilization has additional effects in all above mentioned variables.
Published on: Dec 8, 2016 Pages: 46-52
Thomas F. George
University of Missouri - St. Louis, USA
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