PRWE application in distal radius fracture: comparison and correlation with established outcomes

Paranaíba, Vinícius Ferreira; Santos, João Baptista Gomes dos; Neto, Jorge Raduan; Moraes, Vinícius Ynoe de; Belotti, João Carlos; Faloppa, Flávio

doi:10.1016/j.rboe.2016.07.007

Cited by 12 publications

(13 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…20 The PRWE represents a validated outcome score specifically evaluating the wrist and distal radius fractures. 38,39 The maximal functional improvement and most change in PRWE score after sustaining a distal radius fracture Table 7 Radiographic parameters were measured at the time of each clinical follow-up Note: There were no statistical differences noted between the BFR and control group for any time point as well as in the BFR group before initiation of BFR and at terminal follow-up.…”

Section: Discussionmentioning

confidence: 99%

Blood Flow Restriction Therapy after Closed Treatment of Distal Radius Fractures

2019

View full text Add to dashboard Cite

Background Blood flow restriction (BFR) therapy is an innovative rehabilitative program that enables patients to increase strength at a fraction of the weight typically necessary in endurance exercises. Therefore, we conducted a pilot study evaluating patient outcomes with a BFR therapy program for closed management after a distal radius fracture compared to a traditional rehabilitation protocol. Literature review A randomized-controlled study was conducted comparing a standardized hand therapy rehabilitation protocol alone to a combined protocol with the use of BFR therapy in patients who were initially treated with closed reduction and short arm cast immobilization for a displaced distal radius fracture between May 1, 2015 and August 1, 2016. BFR therapy was performed with a restrictive tourniquet applied to the upper brachium, performing the same strengthening exercises as the control group but with the restrictive tourniquet in place. Clinical assessment was conducted at 6, 10, and 14 weeks from the date of initial cast immobilization. Outcome measures collected included wrist range of motion; grip strength; pinch strength; visual analogue scale for pain with activity and at rest; patient-rated wrist evaluation (PRWE) scores; and disabilities of the arm, shoulder, and hand scores. Results Thirteen patients were enrolled and randomized between the BFR (n = 6) and control (n = 7) groups. The BFR group noted significantly greater reduction in pain with activity compared to the control group after 8 weeks of therapy (Δ −4.0 vs. −2.3, p = 0.03). Similarly, patients in the BFR group displayed greater reduction in PRWE scores compared to the control group after 8 weeks of BFR therapy (Δ −57.9 vs. 30.8, p = 0.01). The two groups did not demonstrate any significant difference in radiographic outcomes at any time point or throughout the course of the study. All patients tolerated the BFR therapy program and there were no complications. Clinical relevance The addition of BFR therapy to the rehabilitative program after closed management of a distal radius fracture is safe, well tolerated by patients, without any deleterious effects on radiographic outcomes. This pilot study noted that BFR therapy in patients with nonoperative distal radius fractures may result in a larger reduction in pain with activity and greater improvement in overall self-perceived function.

show abstract

Section: Discussionmentioning

confidence: 99%

Blood Flow Restriction Therapy after Closed Treatment of Distal Radius Fractures

2019

View full text Add to dashboard Cite

show abstract

“…The DASH is a validated tool to measure outcomes of upper limb injuries, including DRF . Although there are other techniques of outcome measures following DRF management such as Patient Reported Wrist Evaluation (PRWE), it has been reported that there is a strong correlation between DASH and PRWE scores . Some authors used pain scores to assess the outcome of DRF .…”

Section: Methodsmentioning

confidence: 99%

“…4,[12][13][14][15][16] Although there are other techniques of outcome measures following DRF management such as Patient Reported Wrist Evaluation (PRWE), it has been reported that there is a strong correlation between DASH and PRWE scores. 16 Some authors used pain scores to assess the outcome of DRF. 4 However, DASH has designated questions (question no.…”

Section: Dash Questionnairementioning

confidence: 99%

Management of distal radius fractures in the emergency department: A long‐term functional outcome measure study with the Disabilities of Arm, Shoulder and Hand (DASH) scores

Barai

Lambie

Cosgrave

et al. 2018

Emerg Medicine Australasia

View full text Add to dashboard Cite

show abstract

“…[39][40][41][42][43] The PRWE score is a validated method to determine functional disability following DRFs. 24,44,45 Regardless of whether a patient is treated by operative or nonoperative means following a DRF, most improvements in strength, ROM, and function are typically made within the first 3 to 6 months. 11 Similarly, in a meta-analysis of DRFs stabilized with volar plate fixation, significant improvements in PRWE scores were seen within the first 6 months before scores plateaued.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Blood Flow Restriction Therapy after Operative Management of Distal Radius Fractures: A Randomized Controlled Study

2020

View full text Add to dashboard Cite

Background Blood flow restriction (BFR) therapy is an emerging addition to rehabilitative programs that allows patients to increase strength at lower loads over shorter time periods. Therefore, we conducted a study to evaluate the safety and efficacy of a rehabilitation program using BFR to a traditional rehabilitation protocol following operative fixation of distal radius fractures. Methods A randomized controlled study was conducted comparing a standardized rehabilitation protocol alone to a combined protocol with the use of BFR therapy in patients treated with volar plate fixation following a displaced distal radius fracture. The same exercises done in the control group were performed by the BFR group with a restrictive tourniquet in place. Patients were followed with serial radiographs to ensure fracture stability. Outcome measures included wrist range of motion, grip strength, pinch strength, visual analog scale (VAS) pain scores at rest and during activity, patient rated wrist evaluation scores (PRWE), and disabilities of the arm, shoulder, and hand scores. Results Nine patients were randomized and enrolled within the BFR group (n = 5) and control (n = 4) groups. Patients within the BFR group had a significantly greater reduction in pain with activity over the course of the rehabilitation program. Additionally, the BFR group had a significant improvement in PRWE scores during the 8-week rehabilitation program. There was no difference in radiographic measures after initiation of BFR, and all patients tolerated therapy without noted complications. Conclusion BFR therapy is safe and well tolerated after operatively treated distal radius fractures. The addition of BFR therapy can result in quicker reduction in pain with activity and improvement in patient disability when used early following operative management of a distal radius fracture. Level of Evidence This is a Level 1, prognostic study.

show abstract

PRWE application in distal radius fracture: comparison and correlation with established outcomes

Cited by 12 publications

References 28 publications

Blood Flow Restriction Therapy after Closed Treatment of Distal Radius Fractures

Blood Flow Restriction Therapy after Closed Treatment of Distal Radius Fractures

Management of distal radius fractures in the emergency department: A long‐term functional outcome measure study with the Disabilities of Arm, Shoulder and Hand (DASH) scores

Safety and Efficacy of Blood Flow Restriction Therapy after Operative Management of Distal Radius Fractures: A Randomized Controlled Study

Contact Info

Product

Resources

About