Highlights
- •Purposeful activity produces substantial wrist and forearm movement.
- •Wrist active end ROM is similar during purposeful activity and ROM exercises.
- •Movement is more continuous and repetitious during purposeful activity than ROM exercises.
- •Purposeful activity is a valuable source of postoperative therapeutic movement.
Abstract
Purpose
Following surgical repair of distal radius fractures, range of movement (ROM) exercises
are the primary approach for restoring movement during early rehabilitation. Specified
purposeful activities can also be used, but the movement produced by activities is
not well-understood. The study aimed to evaluate and compare movement during purposeful
activity and ROM exercises
Methods
Thirty-five adults with a surgically repaired distal radius facture undertook two
10-minutes interventions: purposeful activity (PA) and active ROM exercises (AE),
separated by a 60 minute washout, in random order. Data collection occurred during
a single session on the same day. Electrogoniometry was used to measure time-accumulated
position (TAP), a global metric of movement range and amount, maximum active end range,
movement repetitions, excursions >75% of available ROM, and active time. Data were
analyzed using linear mixed and generalized linear mixed regression models.
Results
Purposeful activities selected were predominantly household or food preparation. TAP
was significantly higher during AE than PA: -1878 [-2388, -1367], p ≤.001, for wrist extension/flexion. PA produced significantly greater movement repetitions
for wrist extension/flexion and deviation, excursions beyond 75% of available ROM,
and active time, than AE. During PA the wrist was extending/flexing a mean of 97%
[92, 101], of the time, compared with 43% [40, 47], during AE. There were no significant
differences in maximum end range for wrist extension between PA, 33.7° [29.8, 37.5]
and AE, 34.5° [30.7, 38.4], or for ulnar deviation.
Conclusions
ROM exercises produced higher volumes of sustained joint position than purposeful
activity but activities, selected for importance and challenge, produced significantly
higher volumes of continuous, repetitious motion in equivalent ranges of movement
as exercise repetitions. The study challenges therapists to consider the rehabilitative
potential of movement produced by activity for restoring movement and function in
the early postoperative weeks.
Keywords
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Article info
Publication history
Published online: August 08, 2022
Accepted:
July 3,
2022
Received in revised form:
April 7,
2022
Received:
November 8,
2021
Publication stage
In Press Corrected ProofFootnotes
Conflict of interest: All named authors hereby declare that they have no conflicts of interest to disclose.
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