title: Efficacy of combined physical and occupational therapy in patients with conservatively treated distal radius fracture: randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the efficacy of combined physical and occupational therapy in comparison with physical therapy alone in patients with conservatively treated distal radius fracture.
  
  
  METHODS
  Sixty-one participants, conservatively treated after a distal radius fracture, were included in a randomized and single-blind trial. Group A had physical therapy only (n = 31) and group B had physical and occupational therapy (n = 30). The assessment was performed three times: upon inclusion in the study in the first week after removal of the cast (T1), immediately after the end of the rehabilitation (T2), and 1 month after completing the rehabilitation (T3). The passive wrist range-of-motion, grip strength, and Disabilities of Arm, Shoulder and Hand (DASH) score were used as rehabilitation outcomes.
  
  
  RESULTS
  Rehabilitation outcomes were analyzed using two-way mixed analysis of variance. The effect of time was statistically significant (p < 0.001) for all outcomes. The group (therapy) factor was statistically significant for grip strength only (p = 0.038). The interaction effect was statistically significant for rotation (p = 0.034) and grip strength (p = 0.021). A comparison between time points T3:T1 showed statistically significant difference in grip strength in favor of group B 67 % (95 % CI 60-74 %) versus group A 53 % (95 % CI 45-61 %), p = 0.024.
  
  
  CONCLUSIONS
  The combined therapy resulted in a statistically significant increase of grip strength in comparison with isolated physical therapy in the period of 12-16 weeks after the fracture. This effectiveness was not confirmed with DASH score results.
authors.affiliation: Physical and Rehabilitation Medicine Service, Murska Sobota General Hospital, Rakičan, Ul. dr. Vrbnjaka 6, 9000, Murska Sobota, Slovenia.
authors.forename: Verica
authors.initials: V
authors.lastname: Filipova
authors.affiliation: Institute of Physical and Rehabilitation Medicine, University Clinical Centre Maribor, Ljubljanska ul. 5, 2000, Maribor, Slovenia. dragan.lonzaric@ukc-mb.si.|Faculty of Medicine, Department of Physical and Rehabilitation Medicine, University of Maribor, Taborska ul. 6, 2000, Maribor, Slovenia. dragan.lonzaric@ukc-mb.si.
authors.forename: Dragan
authors.initials: D
authors.lastname: Lonzarić
authors.affiliation: Institute of Physical and Rehabilitation Medicine, University Clinical Centre Maribor, Ljubljanska ul. 5, 2000, Maribor, Slovenia.|Faculty of Medicine, Department of Physical and Rehabilitation Medicine, University of Maribor, Taborska ul. 6, 2000, Maribor, Slovenia.
authors.forename: Breda
authors.initials: B
authors.lastname: Jesenšek Papež
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D026741:Physical Therapy Modalities; D011885:Radius Fractures / Q000175:diagnosis* / Q000628:therapy*; D020127:Recovery of Function; D014954:Wrist Injuries / Q000175:diagnosis* / Q000628:therapy*
keywords: Conservative treatment; Distal radius fracture; Grip strength; Occupational therapy; Physical therapy