Physical therapy in patients with complex regional pain syndrome type I after distal radius fracture: a case series.
Héctor Gutiérrez-Espinoza, Andrea Tabach-Apraiz, María Oyanadel-Maldonado
PMID 31037018WHAT IT FOUND
In older adults with complex regional pain syndrome after wrist fracture, a six-week physical therapy program significantly reduced pain and improved hand function.
Grip strength did not improve significantly, so patients may still struggle with force despite feeling less pain.
Key findings
01Function and pain improved significantly after the program, with reductions in scores on the Patient-Rated Wrist Evaluation and Disabilities of the Arm, Shoulder and Hand questionnaires, as well as on the Visual Analog Scale.
02Grip strength increased by 14.4% relative to the unaffected side, but this change was not statistically significant.
03The program combined whirlpool exercises, joint mobilization, and motor skill training over 12 sessions in six weeks.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study lacked a control group and randomization, making it impossible to determine if the improvements were due to the specific treatment or natural history. The follow-up period was short (six weeks), so long-term outcomes are unknown. The sample was restricted to patients over 60 years with conservative fracture treatment, limiting generalizability to younger patients or those with surgical interventions. As a case series, it cannot establish causality or rule out placebo effects.
Declared interests
The authors received no financial support and declared no conflicts of interest.
The easy way to misread this
Do not assume this program will restore grip strength quickly, as the change in strength was not statistically significant despite improvements in pain and function. Also, remember this was a case series without a control group, so the observed improvements cannot be definitively attributed to the therapy rather than natural recovery or placebo.