Coughlin Tim, Norrish Alan R, Scammell Brigitte E, Matthews Paul A, Nightingale Jessica, Ollivere Ben J
Nottingham University Hospitals, Nottingham, UK.
Queen Elizabeth Hospital, King's Lynn, UK.
Bone Joint J. 2021 Jun;103-B(6):1033-1039. doi: 10.1302/0301-620X.103B.BJJ-2020-2026.R1. Epub 2021 Apr 30.
Following cast removal for nonoperatively treated distal radius fractures, rehabilitation facilitated by advice leaflet and advice video were compared to a course of face-to-face therapy.
Adults with an isolated, nonoperatively treated distal radius fracture were included at six weeks post-cast removal. Participants were randomized to delivery of rehabilitation interventions in one of three ways: an advice leaflet; an advice video; or face-to-face therapy session(s). The primary outcome measure was the Disabilities of the Arm, Shoulder and Hand (DASH) score at six weeks post intervention and secondary outcome measures included DASH at one year, DASH work subscale, grip strength, and range of motion at six weeks and one year.
A total of 116 (97%) of 120 enrolled participants commenced treatment. Of those, 21 were lost to follow-up, resulting in 30 participants in the advice leaflet, 32 in the advice video, and 33 face-to-face therapy arms, respectively at six weeks of follow-up. There was no significant difference between the treatment groups in the DASH at six weeks (advice leaflet vs face-to-face therapy, p = 0.69; advice video vs face-to-face therapy, p = 0.56; advice leaflet vs advice video, p = 0.37; advice leaflet vs advice video vs face-to-face therapy, p = 0.63). At six weeks, there were no differences in any secondary outcome measures except for the DASH work subscale, where face-to-face therapy conferred benefit over advice leaflet (p = 0.01).
Following cast removal for nonoperatively treated distal radius fractures, offering an advice leaflet or advice video for rehabilitation gives equivalent patient-reported outcomes to a course of face-to-face therapy. Cite this article: 2021;103-B(6):1033-1039.
对于非手术治疗的桡骨远端骨折，在拆除石膏后，比较由建议手册和建议视频辅助的康复治疗与面对面治疗疗程的效果。
纳入在拆除石膏六周后，患有孤立性、非手术治疗的桡骨远端骨折的成年人。参与者被随机分配以三种方式之一接受康复干预：建议手册；建议视频；或面对面治疗课程。主要结局指标是干预六周后的手臂、肩部和手部功能障碍（DASH）评分，次要结局指标包括一年后的DASH评分、DASH工作分量表、握力以及六周和一年时的活动范围。
120名登记参与者中有116名（97%）开始治疗。其中，21名失访，在六周随访时，分别有30名参与者接受建议手册治疗、32名接受建议视频治疗、33名接受面对面治疗。治疗组之间在六周时的DASH评分无显著差异（建议手册与面对面治疗，p = 0.69；建议视频与面对面治疗，p = 0.56；建议手册与建议视频，p = 0.37；建议手册与建议视频与面对面治疗，p = 0.63）。在六周时，除了DASH工作分量表外，任何次要结局指标均无差异，在该分量表中，面对面治疗比建议手册更具优势（p = 0.01）。
对于非手术治疗的桡骨远端骨折，在拆除石膏后，提供建议手册或建议视频进行康复治疗，与面对面治疗疗程相比，患者报告的结局相当。引用本文：2021;103-B(6):1033-1039。
