gms | German Medical Science

Objective: To assess the clinical effectiveness of a tablet app compared to conventional programs in paper for home exercises program (HEP).

Materials and Methods: Trauma surgery services selected 32 patients with diagnosis of distal radius fracture and single volar plate fixation to be enrolled. This prospective clinical trial compared subjects who received access to the app home exercise program (experimental group (EG)) with those who received home exercise program guided by paper sheet (control group (CG)) one week after surgery. At one week (baseline measure) and 3 months postsurgery, manual dexterity through Nine Hole Peg Test, grip strength and range of motion were evaluated. Additionally, Patient Rated Wrist Evaluation (PRWE) and pain according to the Visual Analog Scale score were analyzed. Physiotherapy service conducted an initial session to instruct patients in their HEP and performed weekly follow-ups via telephone call in the CG and through app Dashboard in the EG.

Results: EG showed statistically significant improvement in PRWE (EG mean difference (MD): -48.27 points, CG MD: -16.83 points, p=0.0015), grip strength (EG MD: 21.41 lb, CG MD: 11.25, p=0.0075), EVA (EG MD:-2.94 points, CG MD: -0.38 points, p=0.007), flexion goniometry (EG MD: 16.62 degrees, CG MD: 5.57 degrees, p=0.0175), extension goniometry (EG MD: 21.53 degrees, CG MD: 10.50 degrees, p=0.008). Dexterity showed an improvement near significant: EG MD: - 10.79 seconds, CG MD: -7.16 seconds, p=0.058.

Conclusions: We suggest that app home exercise program is more effective for improving function, grip strength, pain, flexion and extension range of motion in the medium term compared with paper brochure home exercise program. Clinical and cost-effective results with higher sample and long-term assessments are forthcoming.