& Purpose: Rehabilitation is an integral part of the concept for wrist fractures treated through immobilization. Our aim was to determine the eff ect of two diff erent 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 signifi cantly higher grip strength (83 % vs. 67 % of the starting base value; p = 0.0203). There were no diff erences in the range of motion of pronation / supination, extension and fl exion, or ulnar and radial abduction. However, self training patients showed a signifi cantly greater improvement of the functionality of the wrists according to PRWE score (8.4 vs. 22.5; p = 0.0029). Discussion: The eff ectiveness 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 eff ective alternative to prescribed rehabilitation treatment.
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