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Trial registered on ANZCTR
Registration number
ACTRN12616001715460
Ethics application status
Approved
Date submitted
20/11/2016
Date registered
14/12/2016
Date last updated
14/12/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Does a hand strength exercise program improve grip strength in elderly patients with wrist fractures?
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Scientific title
Does a hand strength exercise program improve grip strength in elderly patients with wrist fractures treated non-operatively? A Randomized Control Trial
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Secondary ID [1]
290583
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none
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
distal radius fracture
301039
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Condition category
Condition code
Physical Medicine / Rehabilitation
300827
300827
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0
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Other physical medicine / rehabilitation
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Injuries and Accidents
301076
301076
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0
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Fractures
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
intervention:
A 4 week schedule of specific hand strength exercises to perform on a daily basis at home between 2 and 6 weeks after injury
Patients will tick off a check sheet regarding adherence to the exercises and this will be collected at the 6 week mark.
The exercises to be performed in the intervention group have been discussed with the supervisor who is a hand surgeon and the physiotherapist. It will consist of 3 categories; Finger range of motion, isometric finger exercises and the use of a squeeze ball given to the patient.
The finger range of motion exercises and isometric finger exercises will be performed in the 1st week with the use of the squeeze ball to be introduced in the 2nd week and consistently used in the 3rd and 4th week.
In the intervention group, the exercises will be explained to the patient at their fracture clinic follow up on recruitment. The surgeon will explain to the participant the exercises in a 1 half hour session. Each exercise is explained to the patient clearly by the surgeon showing the patient with their own hand, and the participant then performing the exercise with their normal hand then their injured hand.
The participant will then receive a 4 week schedule to follow explaining the exercises daily and a checklist to tick off to ensure that the participant is following the exercise program.
If the participant has any questions after the visit during the 4 weeks, they are advised to contact the investigator or the surgeon for further explanation.
There is no specific duration in which the participant must complete the exercises daily. They have a set regime i.e. finger isometric exercises each finger 10 times a day in which is advised to carry out within a day, but not within a time limit of that day.
The intervention group will have a cast. The same as the control group. The short arm fibreglass cast will however have enough room to enable the participant to make a fist, and be able to touch each finger and thumb together, allowing free movement of the thenar eminence.
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Intervention code [1]
296447
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Rehabilitation
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Comparator / control treatment
Control:
For all distal radius fractures managed non operatively, they are placed in a short arm full fibreglass cast at 2 weeks for a total of 4 weeks.
During this period they are asked to move their fingers however there are no specific exercises given.
Our control group will be the normal practice at our institution between 2 and 6 weeks after distal radius fracture of asking the patients to move their fingers.
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Control group
Active
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Outcomes
Primary outcome [1]
300250
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Grip strength will be measured using a JAMAR hand-grip dynamometer
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Assessment method [1]
300250
0
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Timepoint [1]
300250
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3 months post injury
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Secondary outcome [1]
329495
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QUICK-DASH score
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Assessment method [1]
329495
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Timepoint [1]
329495
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3 months post injury
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Secondary outcome [2]
329496
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visual analogue scale - pain
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Assessment method [2]
329496
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Timepoint [2]
329496
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3 months post injury
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Secondary outcome [3]
329497
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Complex regional pain syndrome will be assessed using the Budapest Criteria
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Assessment method [3]
329497
0
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Timepoint [3]
329497
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3 months post injury
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Eligibility
Key inclusion criteria
distal radius fracture in patients over the age of 60
single sided fracture
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Minimum age
60
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
bilateral distal radius fracture
existing neurological condition which has lead to weakness in the ipsilateral limb
prior distal radius fracture in same arm
prior hand or wrist surgery in same arm
patients with dementia or unable to follow instructions
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised sequence generation in blocks
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
1/05/2016
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Date of last participant enrolment
Anticipated
29/12/2017
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
36
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
6959
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Concord Repatriation Hospital - Concord
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Recruitment postcode(s) [1]
14650
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2139 - Concord
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Funding & Sponsors
Funding source category [1]
295170
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Hospital
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Name [1]
295170
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Concord Hospital
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Address [1]
295170
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Concord Hospital
Hospital Road
Concord West 2139
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Country [1]
295170
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Australia
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Primary sponsor type
Individual
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Name
Dr Jai Sungaran
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Address
Concord Hospital
Hospital Road
Concord West NSW 2139
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Country
Australia
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Secondary sponsor category [1]
293832
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None
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Name [1]
293832
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NA
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Address [1]
293832
0
NA
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Country [1]
293832
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296367
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Sydney Local Health District Human Research Ethics Committee
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Ethics committee address [1]
296367
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Concord Repatriation General Hospital (CRGH) Hospital Road Concord NSW 2139
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Ethics committee country [1]
296367
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Australia
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Date submitted for ethics approval [1]
296367
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26/11/2015
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Approval date [1]
296367
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15/03/2016
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Ethics approval number [1]
296367
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CH62/6/2015-181
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Summary
Brief summary
Wrist fractures are amongst the most common fractures suffered by elderly patients. There is limited data regarding grip strength of elderly patients who have suffered a distal radius fracture at the 2 and 6 week mark post injury. We performed a pilot study in the last year investigating grip strength in patients with distal radius fractures at 2 and 6 weeks post injury to determine whether they could drive. One major finding was that patients over the age of 60 who suffered a distal radius fracture had around 0-5kg of grip strength when measured at 2 and 6 weeks post injury. We also found that most patients were given a physiotherapy handout of range of motion exercises which they could perform. There was no strict guideline or recommendation of how often to perform the exercises and there were no grip strength exercises recommended. Grip strength in elderly patients has been noted to be a good indicator of function. Maintenance of function in the elderly patient is of great importance to a patient’s independence in mobility and activities of daily living. We hypothesize that a grip strength focused exercise program given to elderly patients with distal radius fractures will significantly improve patients’ grip strength and therefore function. This study would be of clinical significance to the elderly patient who suffers a wrist fracture. If we can improve a person’s grip strength and function, we may also improve their quality of life. Aim/Objective: To determine whether an exercise program will improve grip strength in elderly patients with distal radius fractures treated nonoperatively. Secondary objective 1. Determine whether an exercise program will improve pain in elderly patients with distal radius fractures 2. To determine whether an exercise program will improve function and reduce complex regional pain syndrome Hypothesis We hypothesize that adherence to a grip strength focused exercise program for a month between 2 weeks and 6 weeks post injury will improve grip strength in elderly patients who suffer a distal radius fracture.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
70610
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Dr Jai Sungaran
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Address
70610
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Concord Repatriation General Hospital (CRGH)
Hospital Road
Concord NSW 2139
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Country
70610
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Australia
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Phone
70610
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+61 2 97675000
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Fax
70610
0
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Email
70610
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[email protected]
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Contact person for public queries
Name
70611
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Antony Nguyen
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Address
70611
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Concord Repatriation General Hospital (CRGH)
Hospital Road
Concord NSW 2139
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Country
70611
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Australia
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Phone
70611
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+61 2 97675000
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Fax
70611
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Email
70611
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[email protected]
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Contact person for scientific queries
Name
70612
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Antony Nguyen
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Address
70612
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Concord Repatriation General Hospital (CRGH)
Hospital Road
Concord NSW 2139
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Country
70612
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Australia
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Phone
70612
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+61 2 97675000
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Fax
70612
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Email
70612
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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