Effectiveness of Closed Kinetic Chain Exercises in Distal Radius Fracture

NCT06811480 | Completed

• 1 other identifier: E-10840098-202.3.02-7483
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to evaluate the effectiveness of closed kinetic chain exercises during the physiotherapy and rehabilitation process following the healing of a distal radius fracture. A total of 40 participants aged 40-60 years who were diagnosed with distal radius fractures were randomly assigned to two groups: the conventional physiotherapy (CP) group (n=20) and the closed kinetic chain exercise (CKCE) group (n=20). Participants in the CP group underwent a 6-week standard rehabilitation program consisting of conventional physiotherapy sessions conducted 5 days a week. This program included Ultrasound (US), Transcutaneous Electrical Nerve Stimulation (TENS), wrist joint range of motion exercises, stretching exercises, Digiflex, Powerweb, and dumbbell-based strengthening exercises. In the CKCE group, the same CP program was implemented with the addition of CKCE sessions conducted five days a week for 6 weeks. Outcome measures included joint range of motion assessed using the Goniometer Pro mobile application, functionality evaluated with the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, pain intensity measured using the Visual Analog Scale (VAS), and joint position sense assessed through the Active Repositioning Test. CKCE may positively affect joint range of motion, arm functionality, pain, and joint position sense by improving the proprioceptive mechanism in individuals with distal radius fractures.

Conditions

Distal Radius Fractures

Keywords

Closed kinetic chain exercises (CKCE); Rehabilitation; Proprioception; Distal Radius Fractures

Outcome Measures

Primary Outcomes (2)

• JPS testing

  Joint position sense (JPS) testing was conducted using a standardized protocol with a goniometer for active wrist position measurement. Participants, seated with their elbow flexed on a table, had their wrist passively moved to 30º extension to memorize the position. With vision occluded, they moved their wrist to full flexion and attempted to reproduce the 30º extension. The reproduced wrist position was recorded, and the difference from the reference angle determined the JPS deficit. A zero value indicated perfect reproduction, while absolute differences reflected the deficit's magnitude. Two trials' mean values were used for analysis.

  From enrollment to the end of treatment at 8 weeks

• Goniometric Measurement

  In this study, the affected shoulder's flexion, extension, abduction, internal rotation, and external rotation angles will be measured using a goniometer-pro application. Reference values will include 0-180 degrees for flexion and abduction, 45 degrees for extension, and 0-90 degrees for internal and external rotation

  From enrollment to the end of treatment at 8 weeks

Secondary Outcomes (2)

• Visual Analog Scale (VAS)

  From enrollment to the end of treatment at 8 weeks

• Disabilities of the Arm, Shoulder, and Hand (DASH)

  From enrollment to the end of treatment at 8 weeks

Study Arms (2)

conventional physiotherapy (CP) group

ACTIVE COMPARATOR

Participants in the first group underwent conventional physiotherapy interventions for 6 weeks, 5 days per week.

Other: Conventional Physiotherapy

closed kinetic chain exercises (CKCE) group

EXPERIMENTAL

Participants in the second group received a treatment protocol including closed kinetic chain exercises (CKCE) in addition to conventional physiotherapy interventions.

Other: Conventional Physiotherapy; Other: Closed Kinetic Chain Exercise

Interventions

Conventional Physiotherapy OTHER

Participants in the first group underwent conventional physiotherapy interventions for 6 weeks, 5 days per week. These interventions included Ultrasound (US), Transcutaneous Electrical Nerve Stimulation (TENS), wrist joint range of motion exercises, stretching exercises, and strengthening exercises using Digiflex, Powerweb, and dumbbells. The number of repetitions and sets of the exercises was adjusted based on the patients' conditions, following a progressive approach. US was applied to the affected wrist for a total of 30 sessions, 5 days a week, once daily, for 6 minutes at an intensity of 1.5 W/cm², using an underwater application method. TENS was administered at a frequency of 100 Hertz for 20 minutes. All participants received manual stretching exercises for wrist flexion, extension, ulnar and radial deviation, supination, and pronation. These stretches were performed by a physiotherapist, with 5 repetitions in each direction, holding the end position for 20 seconds.

closed kinetic chain exercises (CKCE) group; conventional physiotherapy (CP) group

Closed Kinetic Chain Exercise OTHER

Participants in the second group received a treatment protocol that included closed kinetic chain exercises (CKCE) in addition to conventional physiotherapy. CKCE exercises were performed with 15 repetitions each and involved stabilizing a ball between the hand and the wall in different arm positions, rolling it in multiple directions. Participants also performed weight-shifting exercises against a wall and on a table, holding positions for 6 seconds. Additionally, in a crawling position, they moved their unaffected arm diagonally on both a firm surface and a cushion.

closed kinetic chain exercises (CKCE) group

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Aged between 40-60 years
• Diagnosed with a distal radius fracture
• Applied to Medipol hospitals after the injury and volunteered to participate in the study
• Patients with good cooperation levels will be included in the study

You may not qualify if:

• Having bilateral distal radius fractures
• Having ulna styloid fractures
• Having other orthopedic, neurological, or rheumatological problems involving the ipsilateral upper extremity
• A history of surgery involving the ipsilateral upper extremity
• Associated injuries such as arterial, nerve, or tendon injuries
• Patients without adequate cooperation will be excluded from the study
• Withdrawal Criteria:
• Missing at least one follow-up
• Development of orthopedic or systemic problems unrelated to the trauma

Sponsors & Collaborators

• burak menek: lead

Study Sites (1)

Burak Menek

Istanbul, Beykoz, 34815, Turkey (Türkiye)

Location

Related Publications (1)

• Menek B, Dansuk E. Investigating the effects of closed kinetic chain exercises on joint position sense, functionality, range of motion, and pain in individuals with distal radius fracture: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2025 May 31;17(1):137. doi: 10.1186/s13102-025-01195-2.

  PMID: 40450369 DERIVED

MeSH Terms

Conditions

Wrist Fractures

Condition Hierarchy (Ancestors)

Wrist Injuries; Arm Injuries; Wounds and Injuries; Fractures, Bone

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: January 31, 2025
• First Posted: February 6, 2025
• Study Start: December 6, 2024
• Primary Completion: March 9, 2025
• Study Completion: April 2, 2025
• Last Updated: April 4, 2025

Record last verified: 2025-04

Locations

TU (1)