Background Wrist osteoporotic fractures may be as disabling as vertebral or hip fractures and the functional decline attributed to them is similar to that seen for arthritis and diabetes mellitus. Sometimes these fractures will lead to a painful, debilitating condition with sensory and motor disturbances, changes in vascular tone, temperature and edema- complex regional pain syndrome (CRPS). We found some clinical trials and case reports which conclude that mirror visual feedback therapy (MVFT) improves clinical outcomes and the activity of daily living to patients with hand neurological disorders, including CRPS.
Objectives In this controlled randomized clinical study we tried to investigate the effects of (MVFT) in CRPS type I following osteoporosis wrist fracture.
Methods We included 21 subjects with osteoporotic wrist fracture and early CRPS (duration of 3–4 weeks), with a single hand affected by allodynia, stiffness and vasomotor disturbances, from Physical Medicine and Rehabilitation outpatient clinic. They are randomly assigned into two groups: MVFT group (n=11, simply place a mirror between their two hands and train the patient by asking them to move both hands while watching the reflection of the non-affected hand in the mirror, 10 minutes for each session, four times a day) and Control group (n=10, moved both hands separated by an opaque partition between the arms). All subjects also received conventional therapy. On presentation and after 4 weeks of rehabilitation programme we assessed the wrist flexion and extension with a goniometer and the Patient-Rated Wrist Evaluation (PRWE) a 15-items questionnaire designed to measure wrist pain and disability in activities of daily living.
Results Subjects in the mirror therapy group showed significant improvement in range of motion: extension increased with 50.4% vs. 41.7% and for flexion MVFT achieved 33.2% and Control group 16.8% (P<.001). The rehabilitation programme also increased hand function with better results to 4 weeks PRWE for MVFT group (40.4 vs. 51.8, P=0.003).
Conclusions MVF is a simple, inexpensive, without adverse events treatment option that significantly reduces pain and stiffness and improves hand mobility in early CRPS after osteoporosis wrist fracture.
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Bache SJ, Ankcorn L, Hiller L, Gaffrey A. Two different approaches to physiotherapy management of patients with distal radius fractures. Physiotherapy. 2000;86:383.
Disclosure of Interest None declared