Cyclic pneumatic soft-tissue compression enhances recovery following fracture of the distal radius: a randomised controlled trial

Questions: Does the addition of cyclic pneumatic soft-tissue compression during the 6-week immobilisation period following fracture of the distal radius result in a faster recovery of muscle strength and joint range of motion? Does it result in a larger recovery of muscle strength and joint range of motion immediately after the immobilisation period (at 6 weeks) or four weeks after the immobilisation period (at 10 weeks)? Design: Randomised controlled trial with concealed allocation and assessor blinding. Participants: 21 patients with fracture of the distal radius. Intervention: The experimental group received cyclic pneumatic soft-tissue compression during the 6-week immobilisation period whereas the control group received usual care. Both groups were instructed to actively make a fist 100 times per day during the 6-week immobilisation period and were given an exercise program during the 4-week post-immobilisation period. Outcome measures: Function was measured as power grip, pinch grip, key grip, and supination strength using dynamometry from Week 1 to 10 as well as wrist flexion/extension and forearm supination/pronation range of motion using goniometry from Week 6 to 10. The outcome measures are presented as a percentage of the intact side. Results: The experimental group improved significantly faster than the control group in muscle strength from Week 1 to 10 (p <= 0.001) but not in joint range of motion from Week 6 to 10 (p > 0.05). By Week 6, the experimental group was 12-26% stronger and had 8-14% more range of motion than the control group. By Week 10, the experimental group was 24-29% stronger and had 10-15% more range of motion than the control group. Conclusion: The findings indicate that a larger clinical trial is warranted and should incorporate direct measures of fracture healing.