Objective: To investigate the effects of an action observation (AO) and motor imagery (MI) training compared with the standard care pathway on motor and functional recovery in patients with surgical fixation after distal radial fractures (DRF). Design: Two-armed single-blind randomized controlled trial. Setting: Outpatient hand rehabilitation unit. Participants: Forty right-handed participants (N=40) who underwent surgical fixation for right DRF. Interventions: Participants allocated to AOMI group performed an AO and MI training during immobilization period, whereas participants allocated to control group followed a routinary care pathway. Both groups performed a 5-week rehabilitation program after immobilization end. Main outcome and measures: Primary outcome was hand dexterity (Purdue Pegboard Test). Secondary outcomes were active range of motion, pinch and grip strength, and hand function (Patient-Rated Wrist/Hand Evaluation [PRWHE]). Outcomes were assessed at the end of immobilization, after a 5-week rehabilitation program, and at 6-month follow-up. Results: AOMI group revealed better R-task score of the PPT (mean difference: 1.9; 95% CI, 0.8-3.0), PRWHE-pain (median difference: -6.0; 95% CI, -11.0 to -1.0), and PRWHE-specific-activity (median difference: -10.0; 95% CI, -18.0 to -2.0) subscores and total PRWHE score (median difference: -12.8; 95% CI, -23.8 to -4.0) compared with control group at physiotherapy program end. Moreover, AOMI group revealed higher pinch and grip strength than control group at immobilization end (median difference: grip 4.6, 95% CI, 2.0-7.7; pinch 1.9, 95% CI, 0.3-3.2). Conclusions: AO and MI during the immobilization period accelerated the recovery of hand dexterity and function in patients with surgical fixation for DRF. These findings suggested the incorporation of AO and MI in the care pathway of patients undergoing immobilization after surgery for DRF.
Action Observation and Motor Imagery During Hand Immobilization Period Accelerate Motor and Functional Recovery in Patients With Surgical Fixation for Distal Radial Fractures: A Randomized Controlled Trial
Temporiti, Federico;Gatti, Roberto
2025-01-01
Abstract
Objective: To investigate the effects of an action observation (AO) and motor imagery (MI) training compared with the standard care pathway on motor and functional recovery in patients with surgical fixation after distal radial fractures (DRF). Design: Two-armed single-blind randomized controlled trial. Setting: Outpatient hand rehabilitation unit. Participants: Forty right-handed participants (N=40) who underwent surgical fixation for right DRF. Interventions: Participants allocated to AOMI group performed an AO and MI training during immobilization period, whereas participants allocated to control group followed a routinary care pathway. Both groups performed a 5-week rehabilitation program after immobilization end. Main outcome and measures: Primary outcome was hand dexterity (Purdue Pegboard Test). Secondary outcomes were active range of motion, pinch and grip strength, and hand function (Patient-Rated Wrist/Hand Evaluation [PRWHE]). Outcomes were assessed at the end of immobilization, after a 5-week rehabilitation program, and at 6-month follow-up. Results: AOMI group revealed better R-task score of the PPT (mean difference: 1.9; 95% CI, 0.8-3.0), PRWHE-pain (median difference: -6.0; 95% CI, -11.0 to -1.0), and PRWHE-specific-activity (median difference: -10.0; 95% CI, -18.0 to -2.0) subscores and total PRWHE score (median difference: -12.8; 95% CI, -23.8 to -4.0) compared with control group at physiotherapy program end. Moreover, AOMI group revealed higher pinch and grip strength than control group at immobilization end (median difference: grip 4.6, 95% CI, 2.0-7.7; pinch 1.9, 95% CI, 0.3-3.2). Conclusions: AO and MI during the immobilization period accelerated the recovery of hand dexterity and function in patients with surgical fixation for DRF. These findings suggested the incorporation of AO and MI in the care pathway of patients undergoing immobilization after surgery for DRF.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
