Suero Pineda A1, Blanquero Villar J2, Rodríguez Sánchez-Laulhé P1, Gil Álvarez JJ3, Luque Romero LG4, Cortés Vega MD5
1FISEVI, Seville, Spain, 2University of Seville, Physiotherapy Department, Seville, Spain, 3Hospital Universitario Virgen del Rocío, Head of Hand Surgery Service, Seville, Spain, 4Andalusian Public Health System, Head of Research Department of North Seville District, Seville, Spain, 5University of Seville, Physiotherapy Department, Sevilla, Spain

Background: Distal radius fractures (DRF) represent 15%-20% of total fractures treated in emergency services and suppose a high cost for Andalusian Public Health System (APHS). Home exercises programs (HEP) are effective for patients younger than 60 years and with no complications. HEP have to be personalized, progressive and controlled. Currently methods consist on providing patients with an exercises paper sheet which not compliment these requirements. Adherence control seems to be crucial to short-terms outcomes in DRF. For that purpose, we propose ReHand to implement individualized and controlled HEP in hand therapy. ReHand is a digital tablet tool for wrist, hand and fingers trauma rehabilitation, developed under the guidelines of physiotherapists, hand surgeons and rehabilitators in APHS.

Purpose: To evaluate the short-term effectivity of ReHand versus conventional methods in patients with DRF volar plate fixation in two of leading Andalusian Public Health System (APHS) Hospitals.

Methods: A pilot study was conducted. Trauma surgery services selected 20 patients with diagnosis of distal radius fracture and volar plate fixation to be enrolled in a prospective clinical trial comparing those who received ReHand home exercise program with those enrolled in the conventional home exercise program guided by paper sheet.

Outcomes: dexterity measured in seconds through Nine Hole Peg Test and self-reported functional ability measured by Patient Rate Wrist Evaluation (PRWE) questionnaire. Assessments took place at 4 weeks. Physiotherapy service developed an initial session to instruct patients in their HEP and telephone calls to follow up weekly during the process. Physiotherapists could follow adherence and development of ReHand group through a dashboard. They used this information in the follow ups to solve doubts and improve patient´s adherence and development.

Results: A total of 20 patients between 18 - 60 years were included in the study. Patients who owns a tablet jointed ReHand HEP group (n=10), while control group received paper sheet HEP (n= 10). We found statistically significant improvement in dexterity (ReHand average of difference of - 12.864 seconds, control: -3.059 seconds, p=0.014). We found that patients reported a better functional recovery in ReHand group measured through the PRWE with an average of difference of -31.99 points and -20.85 points in the control group. However, there were no statistically significant changes between groups in this measures (p>0.05), thus we suggest it is due to the lack of sample size.

Conclusion(s): ReHand might be an effective solution for DRF patients after surgery in the short-term. Clinical and cost-effective results with higher sample and middle and long-term assessments are forthcoming.

Implications: Implementation of ReHand in Andalusian Health Public System might have huge effects on rehabilitation process of DRF improving clinical results and providing physiotherapist with a cost-effective tool.

Keywords: distal radius fracture, app, home exercise program

Funding acknowledgements: Health innovation funds from Andalusian Public Health System.

Topic: Musculoskeletal: upper limb; Robotics & technology

Ethics approval required: Yes
Institution: Andalusian Public Health System and Junta de Andalucía
Ethics committee: Biomedical Research Ethics Committee of Andalusia
Ethics number: 25852

All authors, affiliations and abstracts have been published as submitted.

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