title: Therapist-supervised hand therapy versus home therapy with therapist instruction following distal radius fracture.
abstract: OBJECTIVE
  To investigate whether there was a difference in Patient-Rated Wrist Hand Evaluation (PRWHE) scores between patients with and without comorbidities who receive regular supervised therapy provided by a certified hand therapist (CHT) compared with patients who were provided with a home exercise program and were regularly monitored.
  
  
  METHODS
  Fifty patients with a diagnosis of distal radius fractures and volar plate fixation were enrolled in a prospective, randomized clinical trial comparing those who received therapy under the supervision of a CHT with those enrolled in a home exercise program that was instructed and monitored by a CHT. The primary outcome measure (PRWHE) and secondary outcome measures, total arc of motion for wrist flexion and extension, supination and pronation, and grip strength, were assessed at 12 weeks. The primary outcome measure for both groups was also gathered at 6 months.
  
  
  RESULTS
  There were no statistically significant differences between the final scores of the PRWHE, wrist or forearm motion, pain, or grip strength between groups. Effect size calculations revealed that both groups experienced a large effect size for all outcomes.
  
  
  CONCLUSIONS
  Supervised clinic-based therapy is equally beneficial for patients without complications. Clinic-based therapy may be preferable for patients with noteworthy complications after a distal radius fracture with volar plate fixation. Patients with decreased finger motion and various comorbidities may benefit from therapy provided in a clinic under the supervision of a certified hand therapist.
  
  
  METHODS
  Therapeutic II.
authors: Hand Works Therapy, Venice, FL.
authors: Kristin
authors: K
authors: Valdes
authors: Hand Surgery Associates, LLC, Clarks Summit, PA. Electronic address: nancynaughton10@gmail.com.
authors: Nancy
authors: N
authors: Naughton
authors: Professional Orthopaedic Associates, Scranton, PA.
authors: Casey J
authors: CJ
authors: Burke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005593:Fracture Fixation, Internal; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011446:Prospective Studies; D011885:Radius Fractures / Q000534:rehabilitation* / Q000601:surgery*; D016059:Range of Motion, Articular; D012648:Self Care; D064232:Visual Analog Scale; D055815:Young Adult
keywords: Distal radius fracture; home program; occupational therapy; physical therapy