Cross-Education for Improving Strength and Mobility After Distal Radius Fractures: A Randomized Controlled Trial

Abstract Objective To evaluate the effects of cross-education (contralateral effect of unilateral strength training) during recovery from unilateral distal radius fractures on muscle strength, range of motion (ROM), and function. Design Randomized controlled trial (26-wk follow-up). Setting Hospital, orthopedic fracture clinic. Participants Women older than 50 years with a unilateral distal radius fracture. Fifty-one participants were randomized and 39 participants were included in the final data analysis. Interventions Participants were randomized to standard rehabilitation (Control) or standard rehabilitation plus strength training (Train). Standard rehabilitation included forearm casting for 40.4±6.2 days and hand exercises for the fractured extremity. Nonfractured hand strength training for the training group began immediately postfracture and was conducted at home 3 times/week for 26 weeks. Main Outcome Measures The primary outcome measure was peak force (handgrip dynamometer). Secondary outcomes were ROM (flexion/extension; supination/pronation) via goniometer and the Patient Rated Wrist Evaluation questionnaire score for the fractured arm. Results For the fractured hand, the training group (17.3±7.4kg) was significantly stronger than the control group (11.8±5.8kg) at 12 weeks postfracture ( P