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Current Reviews in Musculoskeletal Medicine

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01-04-2021 | Distal Radius Fracture | Hot Topics

The Benefits and Harms of Early Mobilization and Supervised Exercise Therapy after Non-surgically Treated Proximal Humerus or Distal Radius fracture: A systematic Review and Meta-analysis

Authors: Helle K. Østergaard, Inger Mechlenburg, Antti P. Launonen, Marianne T. Vestermark, Ville M. Mattila, Ville T. Ponkilainen

Published in: Current Reviews in Musculoskeletal Medicine | Issue 2/2021

Abstract

Purpose of Review

Fractures of the proximal humerus (PHF) and distal radius (DRF) are among the most common upper extremity fractures in the elderly. Recent randomized controlled trials support non-surgical treatment. Evidence behind the best non-surgical treatment strategy has been sparse and raises questions as to when and how to initiate exercises. The purpose of this systematic review and meta-analysis was to assess the benefits and harms of early mobilization versus late mobilization and supervised versus non-supervised exercises therapy after PHF and DRF.

Recent Findings

15 published and 5 unpublished trials were included. Early mobilization after PHF resulted in better function with a mean difference (MD) of 4.55 (95% CI 0.00–9.10) on the Constant Shoulder Score. However, the MD was not found to be clinically relevant. No clear evidence showed that early mobilization after PHF had a positive effect on range of motion or pain. Neither did it lead to more complications. Furthermore, no eligible evidence was found supporting early mobilization to be superior to late mobilization after DRF, or that supervised exercise therapy was superior to non-supervised exercise therapy after PHF and DRF. The quality of evidence on all outcomes was found to be low or very low.

Summary

Early mobilization after PHF may have a beneficial effect on function. Due to the lack of clear evidence, there is an urgent need for future studies to determine the effect of early mobilization and supervised exercise therapy after PHF and DRF.

Prospero ID number: CRD42020167656, date of registration 28.04.2020

Available only for authorised users

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Title: The Benefits and Harms of Early Mobilization and Supervised Exercise Therapy after Non-surgically Treated Proximal Humerus or Distal Radius fracture: A systematic Review and Meta-analysis
Authors: Helle K. Østergaard
Inger Mechlenburg
Antti P. Launonen
Marianne T. Vestermark
Ville M. Mattila
Ville T. Ponkilainen
Publication date: 01-04-2021
Publisher: Springer US
Keywords: Distal Radius Fracture
Exercise Therapy
Exercise Therapy
Published in: Current Reviews in Musculoskeletal Medicine / Issue 2/2021
Electronic ISSN: 1935-9748
DOI: https://doi.org/10.1007/s12178-021-09697-5

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The Benefits and Harms of Early Mobilization and Supervised Exercise Therapy after Non-surgically Treated Proximal Humerus or Distal Radius fracture: A systematic Review and Meta-analysis

Abstract

Purpose of Review

Recent Findings

Summary

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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