Background: A distal radius fracture (DRF) requires immobilization, affecting functional skills, strength, and bimanual activities at one-to-two years post-injury. This research design added bimanual activity to a standard occupational therapy (OT) treatment protocol and home exercise program (HEP) to increase the speed of bimanual activity and improve functional skills for patients with open reduction with internal fixation (ORIF) after a DRF.
Methods: This quasi-experimental study used a single-group pretest-posttest design of individuals with DRF requiring ORIF. A HEP with 10 minutes of bimanual activity was added to a standard OT treatment protocol and performed twice daily. Primary outcome measures were the Michigan Hand Outcome Questionnaire (MHQ) and the Purdue Pegboard Test (PPT).
Results: The participants showed a statistically significant change in the overall MHQ ADL and total MHQ scores (p < .001) and all domains except for work performance and aesthetics. Based on the pre-established minimally clinically important difference of 13-point change, there was a clinically relevant change in the majority of the MHQ measurements. Participants showed statistically significant improvement (p < .001) with large effect size (1.50) for the PPT bimanual assembly peg placement.
Discussion: Participants demonstrated improvements in bimanual activities, pain, and functional skills as measured with the MHQ after adding bimanual activities to the OT treatment. The statistically significant changes in the PPT scores showed improved hand dexterity and bimanual skills with increased speed. Large effect size for bimanual assembly confirmed clinical improvement in bimanual tasks within a 4- to 5-week time frame after ORIF.