Occupational Therapy is not superior to Independent Exercises After Volar Plate Fixation .
This report has been verified
by one or more authors of the
original publication.
This study has been identified as potentially high impact.
OE's AI-driven High Impact metric estimates the influence a paper is likely to have by integrating signals from both the journal in which it is published and the scientific content of the article itself.
Developed using state-of-the-art natural language processing, the OE High Impact model more accurately predicts a study's future citation performance than journal impact factor alone.
This enables earlier recognition of clinically meaningful research and helps readers focus on articles most likely to shape future practice.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(3):112 Journal of Bone and Joint Surgery; 2011; 93(A): 1761-1766Exclusive Author Interview
Dr. Ring speaking on occupational therapy after volar plate fixation.
94 patients with unstable distal radial fracture treated with open reduction and volar locking plate fixation were randomized to receive exercise therapy under the supervision of an occupational therapist, or surgeon-directed independent exercises. After 6 month follow, up it was found that patients who conducted independent exercises displayed a significantly higher mean arc of wrist flexion, extension, ulnar deviation and mean grip strength in comparison to those in the occupational therapy group. However, it was also found that there were no significant differences in disability scores between the two groups.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Yes = 1
Uncertain = 0.5
Not Relevant = 0
No = 0
The Reporting Criteria Assessment evaluates the transparency with which authors report the methodological and trial characteristics of the trial within the publication. The assessment is divided into five categories which are presented below.
4/4
Randomization
4/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
The Fragility Index is a tool that aids in the interpretation of significant findings, providing a measure of strength for a result. The Fragility Index represents the number of consecutive events that need to be added to a dichotomous outcome to make the finding no longer significant. A small number represents a weaker finding and a large number represents a stronger finding.
Why was this study needed now?
We all are aware of the potential benefits of the physical and occupational therapy after most surgical procedures. However, uncertainties exist over the the effects of formal occupational therapy on recovery after open reduction and volar plate fixation of the distal radius fracture. This study evaluates the wrist function and arm-specific disability six months after open reduction and volar plate fixation of a distal radial fracture between patients who received and didn't receive the formal occupational therapy.
What was the principal research question?
Does occupational therapy lead to better outcomes in terms of wrist function and arm specific disability in comparison to independent exercises in patients with unstable distal radial fracture treated with open reduction and volar locking plate fixation?
- patients in the independent exercise group had significantly higher pinch strength, grip strength, and Gartland and Werley scores in comparison to those in the occupational therapy group at 3 month follow up (p<0.05)
- the independent group displayed significantly better wrist flexion and extension at 6 month follow up (118 degrees versus 129 degrees, p<0.05)
- DASH scores favored the independent exercise group, but this was not significant (p=0.42)
What should I remember most?
Occupational therapy does not lead to superior function or disability outcomes in comparison to independent exercises in individuals who have undergone open reduction and volar locking plate fixation.
How will this affect the care of my patients?
Although the results of this study do not find any additional benefits for using occupational therapy, further long term studies need to be conducted.
DISCLAIMER
This content found on this page is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you require medical treatment, always seek the advice of your physician or go to your nearest emergency department. The opinions, beliefs, and viewpoints expressed by the individuals on the content found on this page do not reflect the opinions, beliefs, and viewpoints of OrthoEvidence.
0 of 4 monthly FREE articles unlocked
