Department of Occupational Therapy, Health and Rehabilitation Sciences, Western University, London, Ontario, Canada; The Roth McFarlane Hand and Upper Limb Centre, London, Ontario, Canada.
The Roth McFarlane Hand and Upper Limb Centre, London, Ontario, Canada; Department of Physical Therapy, Western University, London, Ontario, Canada.
J Hand Ther. 2018 Jul-Sep;31(3):276-281. doi: 10.1016/j.jht.2017.08.003. Epub 2017 Oct 12.
Blinded randomized controlled trial.
It is generally accepted that heat is beneficial for improving range of motion (ROM). However, the mechanism of action is not clearly understood, and the optimal method of heat application has not been established.
To investigate the immediate effects of using a moist hot pack (MHP) vs therapeutic whirlpool bath (WB) for improving wrist ROM during a therapy session for patients with distal radius fracture.
About 60 adult patients, with a mean age of 54 years in the MHP group and 53 years in the WB group, with healed distal radius fracture were randomized into 2 groups of 30. Patients in group 1 were placed in an MHP for 15 minutes during therapy. Patients in group 2 had their arm placed in a WB and were asked to perform active wrist ROM exercises for the same period. This occurred for 3 consecutive therapy visits, with wrist and forearm ROM being measured before and after heat during each visit.
The multivariate analysis of variance demonstrated that the canonical variate for ROM was significantly different between groups (F[6,53] = 6.01; P < .05), indicating that patients in the WB group had a significantly larger increase in ROM than patients receiving MHP application.
Both WB and MHP improved wrist ROM during therapy sessions in this study, making both these acceptable options for clinical use when the goal is to precondition a patient for other treatments.
Individuals who received WB showed a statistically greater increase in wrist ROM than those receiving MHP during a therapy session, although the difference between groups may or may not be clinically important considering the small changes in ROM observed in this study.
Level II.
盲法随机对照试验。
人们普遍认为热疗有益于改善活动范围（ROM）。然而，其作用机制尚不清楚，也尚未确定最佳的热应用方法。
探讨在治疗桡骨远端骨折患者的过程中，使用湿热袋（MHP）与治疗性涡流浴（WB）即刻改善腕 ROM 的效果。
约 60 名平均年龄为 54 岁（MHP 组）和 53 岁（WB 组）的成年患者，按照完全随机分组方法分为 MHP 组和 WB 组，每组 30 例。组 1 患者在治疗期间接受 15 分钟 MHP；组 2 患者将手臂置于 WB 中，并在同一时间进行主动腕 ROM 运动。连续 3 次治疗访视，每次访视在热疗前后测量腕关节和前臂 ROM。
多变量方差分析表明，ROM 的典型变量在组间差异有统计学意义（F[6,53] = 6.01；P <.05），表明 WB 组的 ROM 增加明显大于接受 MHP 应用的患者。
在本研究中，WB 和 MHP 均在治疗过程中改善了腕 ROM，这两种方法均为临床应用提供了可接受的选择，当目标是为其他治疗预先调节患者时。
在治疗过程中，接受 WB 的个体腕 ROM 增加明显大于接受 MHP 的个体，尽管考虑到本研究中 ROM 观察到的微小变化，组间差异可能具有或不具有临床意义。
二级。
