Effects of Motor Cognitive Training on Functional Loss After Osteoporotic Wrist Fractures

NCT01394809 | Completed

• 1 other identifier: 01 EC 1007D
• Study Type: interventional
• Target: 27
• Locations: 1 country
• Sites: 1

Brief Summary

The therapy results after distal radius fracture especially of elderly patients are often suboptimal. The central problem results from the inevitable, 3-6-weeks immobilization, which leads to reduction in ROM of the wrist, deterioration of muscle strength as well as malfunction of fine motor skills and coordination. Currently, there are no adequate proactive strategies to counteract these immobilisation problems. Hence the overall aim of our research project is to investigate the therapeutic potential of a motor-cognitive therapy on hand function after distal radius fracture. On the one hand the pilot study should provide information about the level of recruitment rate necessitated for an adequate sample size which allows reliable evidence for the therapy effects. On the other hand we want to evaluate the sensitivity and adequacy of the assessment instruments. The pilot is conceived as a controlled, randomised, longitudinal intervention study over 6 weeks with 3 groups. One experimental group imagine movements and actions without executing them. A second experimental group performs mirror training, in which visual feedback through a mirror activates additionally the contralateral hemisphere. The control group receives therapy as usual. There are three key domains to be analysed: function (PRWE), impairment (ROM, strength) and participation in social life/life quality (DASH, EQ5D).

Conditions

Osteoporotic Distal Radius Fracture

Keywords

osteoporosis; wrist fracture; mental practice; mirror therapy; immobilization; elderly

Outcome Measures

Primary Outcomes (1)

• Patient pain and disability

  Patient Rated Wrist Evaluation (PRWE)

  12 weeks

Secondary Outcomes (3)

• subjective hand function

  12 weeks

• objective measurements

  12 weeks

• subjective well-being

  12 weeks

Study Arms (3)

Mental Practice

EXPERIMENTAL

During motor imagery practice a person imagines performing a movement with all its sensory consequences without actually moving. In this study the therapists follow a motor imagery guideline designed for rehabilitation of movement performance. The guideline offers therapists structure and a strategy to deliver subject-specific imagery, and is based on principles of motor learning.

Behavioral: motor cognitive therapies

Mirror Therapy

EXPERIMENTAL

Mirror therapy is thought to work by using vision of the intact or good arm to replace or drive proprioception in the affected arm, and so normalise the afferent segment of the movement process.

Behavioral: motor cognitive therapies

Relaxation training

ACTIVE COMPARATOR

The control group will receive therapy as usual. Currently, this means that patients are immobilized during first 3-4 weeks. The control group will receive additional relaxation training during this period to achieve the same total amount of time the therapist spends with the patients of the experimental groups.

Behavioral: motor cognitive therapies

Interventions

motor cognitive therapies BEHAVIORAL

pre-test; 6 weeks intervention: week 1-3: 5 times per week 60 minutes a day. Week 4-6: 3 times per week 60 minutes a day; post-test; follow-up)

Mental Practice; Mirror Therapy; Relaxation training

Eligibility Criteria

• Age: 65 Years - 85 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• wrist fracture
• age 65 and older

You may not qualify if:

• unstable medical conditions which preclude surgical intervention (ASA 5)
• Patients who do not live independently (nursing home)
• Patients with an open fracture
• Associated soft tissue or skeletal injury to the same limb
• Cognitive impairment (6CIT \< 10)

Sponsors & Collaborators

• University of Stuttgart: lead
• German Federal Ministry of Education and Research: collaborator

Study Sites (1)

Robert Bosch Medical Center

Stuttgart, 70376, Germany

Location

Related Publications (2)

• Schott N, Korbus H. Preventing functional loss during immobilization after osteoporotic wrist fractures in elderly patients: a randomized clinical trial. BMC Musculoskelet Disord. 2014 Aug 30;15:287. doi: 10.1186/1471-2474-15-287.

  PMID: 25175985 BACKGROUND

• Schott, N., Frenkel, M.-O., Korbus, H. & Francis, K. (2013). Mental Practice in Orthopaedic Rehabilitation: Where, What, and How? A case report. Sci-ence et Motricité, 82, 93-103.

  BACKGROUND

MeSH Terms

Conditions

Osteoporosis; Wrist Fractures

Condition Hierarchy (Ancestors)

Bone Diseases, Metabolic; Bone Diseases; Musculoskeletal Diseases; Metabolic Diseases; Nutritional and Metabolic Diseases; Wrist Injuries; Arm Injuries; Wounds and Injuries; Fractures, Bone

Study Officials

• Nadja Schott, phd

  University of Stuttgart

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: July 12, 2011
• First Posted: July 14, 2011
• Study Start: August 1, 2010
• Primary Completion: October 1, 2014
• Study Completion: October 1, 2014
• Last Updated: December 4, 2014

Record last verified: 2014-12

Locations

DE (1)