This single-blinded, randomized controlled trial (RCT) will evaluate the added benefit of mechanical modalities (continuous passive motion (CPM) and intermittent pneumatic compression (IPC)) when integrated into standard therapy for managing postoperative edema and pain in patients undergoing distal radius fracture (DRF) fixation. The primary outcomes are edema volume (measured via volumeter) and pain intensity (Numeric Pain Rating Scale, NPRS) at 6 weeks post-operation. Secondary outcomes include wrist/forearm range of motion (ROM), grip strength, Patient-Rated Wrist Evaluation (PRWE), and adverse events.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
50
Materials: A CPM device configured for wrist flexion-extension with an adjustable range of motion set between 0° and 30°. Procedure: The participant's wrist is gently secured in the device. The CPM device is programmed to deliver 20 minutes of continuous, passive motion through the set range. Device settings (e.g., speed) may be modified if the participant reports pain \>4/10 on the NPRS.
Materials: An IPC sleeve designed for the forearm-to-hand region with a baseline compression setting of approximately 30 mmHg. Procedure: After CPM treatment, the IPC device is applied to the affected limb. The sleeve provides 15 minutes of intermittent compression with programmed intervals of inflation and deflation. Compression levels may be adjusted based on participant comfort and pain ratings.
Procedures: Active/active-assisted wrist/forearm range of motion exercises led by a certified hand/physical therapist. Progressive grip-strengthening exercises using resistance bands or putty. Manual edema management techniques, including gentle massage and manual lymphatic drainage, as well as scar mobilization if needed.
Faculty of Physical Therapy, Al Hayah University
Cairo, Egypt
RECRUITINGEdema Volume
Edema of the wrist/forearm will be quantitatively measured using a volumeter method. Lower volumes are indicative of reduced swelling.
Time frame: Assessed at baseline (2 weeks postoperatively) and at 6 weeks post-operation.
Pain Intensity
Pain is measured using the Numeric Pain Rating Scale (NPRS), with scores ranging from 0 (no pain) to 10 (worst pain imaginable).
Time frame: Assessed at baseline (2 weeks postoperatively) and at 6 weeks post-operation.
Wrist/Forearm Range of Motion (ROM)
Active ROM is measured using a standard goniometer. Improvements in ROM indicate better recovery of function.
Time frame: Measured at baseline, 6 weeks, and 3 months postoperatively.
Grip Strength
Evaluated using a calibrated dynamometer. Increased grip strength is suggestive of improved functional recovery.
Time frame: Assessed at baseline, 6 weeks, and 3 months postoperatively.
Incidence of Adverse Events
All adverse events, including skin irritation or device intolerance, will be monitored and recorded.
Time frame: Continuously monitored from baseline to the 3-month follow-up.
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