Physiotherapy in conservatively managed distal radius fractures

ISRCTN ISRCTN62731680
DOI https://doi.org/10.1186/ISRCTN62731680
Secondary identifying numbers 19314
Submission date
19/11/2015
Registration date
19/11/2015
Last edited
13/05/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
A distal radius fracture, commonly referred to as a broken wrist, is where bone running between the elbow and the thumb (radius) is broken. It can be extremely painful, making it difficult or even impossible to use the affected arm. If the break is “clean” and the broken pieces of bone are in the correct position, then they are usually treated by applying a plaster or fibreglass cast. This works by holding the broken sections of bone together so that they heal in the right position (immobilisation). The cast usually stays in place for at least 6 weeks, to give the bones a chance to heal. Once the cast is removed, many doctors recommend physiotherapy, to help restore strength in the arm muscles and to restore full movement. Physiotherapy is not always available and can be very expensive however, and many health professionals do not feel that it is a necessary part of recovery for those with a broken wrist. It can be argued that many patients could benefit equally well from managing their rehabilitation themselves, such as through self-directed exercises at home. The aim of this study is to compare the long-term effects of having physiotherapy to self-directed exercises on long-term recovery following a distal radius fracture.

Who can participate?
Adults who have had a broken wrist treated using a cast or splint for between 5-7 weeks.

What does the study involve?
Participants are randomly allocated to one of three groups. Those in the first group are given an advice sheet including information about the process of recovery. Those in the second group are given an outpatient appointment with a physiotherapist. Those in the third group are provided with a video that they can watch at home, and will instruct them how to perform rehabilitation exercises that may help their recovery. At the start of the study and then at 6, 12 and 52 weeks, participants complete a number of questionnaires in order to monitor their recovery.

What are the possible benefits and risks of participating?
Not provided at time of registration.

Where is the study run from?
Queens Medical Centre, Nottingham (UK)

When is the study starting and how long is it expected to run for?
October 2015 to August 2017

Who is funding the study?
AOUK (UK)

Who is the main contact?
Miss Jessica Nightingale

Contact information

Miss Jessica Nightingale
Public

Queens Medical Centre
Derby Road
Nottingham
NG7 2UH
United Kingdom

Study information

Study designThree-arm prospective randomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Other
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleOutcomes and cost effectiveness of physiotherapy, self directed therapy and advice sheets following conservatively managed distal radius fractures: A prospective randomised controlled trial
Study objectivesThe aim of this study is to investigate the effects of physiotherapy, self directed therapy and advice sheets on recovery following a distal radial fracture.
Ethics approval(s)East Midlands - Nottingham 2 Research Ethics Committee, 30/07/2015, ref: 15/EM/0297
Health condition(s) or problem(s) studiedTopic: Musculoskeletal disorders; Subtopic: Musculoskeletal (all Subtopics); Disease: Musculoskeletal
InterventionParticipants are randomly allocated to one of three groups.

Group 1: Participants are given an advice sheet and a physiotherapy department leaflet (control group)
Group 2: Participants are provided with an outpatient appointment with physiotherapist
Group 3: Participants are provided with an instructional video that will help them to perform rehabilitation exercises at home.

Participants recovery is assessed at baseline, 6, 12 and 52 weeks for all groups.
Intervention typeOther
Primary outcome measureSymptoms and ability in the affected arm are measured using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire at baseline, 6 , 12 and 52 weeks.
Secondary outcome measures1. EQ5D at baseline, 6 , 12 and 52 weeks
2. Patient Evaluation Measure (PEM) at baseline, 6, 12 and 52 weeks
3. Routine Outcome Measures (ROM) at 6, 12 and 52 weeks
Overall study start date12/10/2015
Completion date01/08/2017

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPlanned Sample Size: 120; UK Sample Size: 120
Total final enrolment120
Key inclusion criteria1. Aged between 18 and 70 years at the time of fracture
2. Able to give informed consent
3. Any fracture of the distal radius within 3cm of the radiocarpal joint will be considered for inclusion (including intraarticular fractures, fractures with comminution, associated ulnar styloid fracture, dorsal and volar displacement patterns) provided it has been deemed suitable for conservative management by the treating physician.
4. Fracture treated with immobilisation (plaster of paris / fibreglass cast / splint) worn constantly for between 5 and 7 weeks
5. English should be the patient's first language
Key exclusion criteria1. A fracture which extends beyond 3 cm of the radiocarpal joint
2. Any patient with bilateral fractures
3. A fracture which has been immobilised outside of the range of 5 and 7 weeks
4. Any patient who is deemed to be unlikely to be able to adhere to the trial procedure or complete the questionnaires (e.g. drug dependence or cognitive impairment)
5. Current participation in another ongoing study
6. Evidence of complex regional pain syndrome
7. Post plaster stiffness of the fingers which prevents the patient from being able to place their hand flat on a tabletop
8. Any previous fracture of the wrist or carpal bones whether treated operatively or conservatively
Date of first enrolment12/10/2015
Date of final enrolment01/08/2017

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Queens Medical Centre
Derby Road
Nottingham
NG7 2UH
United Kingdom

Sponsor information

Nottingham University Hospitals NHS Trust
Hospital/treatment centre

Queens Medical Centre
Derby Road
Nottingham
NG7 2UH
England
United Kingdom

ROR logo "ROR" https://ror.org/05y3qh794

Funders

Funder type

Research organisation

AOUK

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing planNot provided at time of registration

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 01/06/2021 13/05/2022 Yes No
HRA research summary 28/06/2023 No No

Editorial Notes

13/05/2022: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.