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

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

I: Current reviews in musculoskeletal medicine, Bind 14, Nr. 2, 04.2021, s. 107-129.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisReviewForskningpeer review

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@article{4602b3a4bc4e4bca820a99aedcaae564,
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",
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 Recent Findings: 15 published and 5 unpublished trials were included.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.",
keywords = "Distal radius fracture, Early mobilization, Non-surgical treatment, Proximal humerus fracture, supervised exercise therapy",
author = "{\O}stergaard, {Helle K.} and Inger Mechlenburg and Launonen, {Antti P.} and Vestermark, {Marianne T.} and Mattila, {Ville M.} and Ponkilainen, {Ville T.}",
year = "2021",
month = apr,
doi = "10.1007/s12178-021-09697-5",
language = "English",
volume = "14",
pages = "107--129",
journal = "Current reviews in musculoskeletal medicine",
issn = "1935-973X",
publisher = "Humana Press",
number = "2",

}

RIS

TY - JOUR

T1 - The Benefits and Harms of Early Mobilization and Supervised Exercise Therapy after Non-surgically Treated Proximal Humerus or Distal Radius fracture

T2 - A systematic Review and Meta-analysis

AU - Østergaard, Helle K.

AU - Mechlenburg, Inger

AU - Launonen, Antti P.

AU - Vestermark, Marianne T.

AU - Mattila, Ville M.

AU - Ponkilainen, Ville T.

PY - 2021/4

Y1 - 2021/4

N2 - 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.

AB - 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.

KW - Distal radius fracture

KW - Early mobilization

KW - Non-surgical treatment

KW - Proximal humerus fracture

KW - supervised exercise therapy

UR - http://www.scopus.com/inward/record.url?scp=85102464255&partnerID=8YFLogxK

U2 - 10.1007/s12178-021-09697-5

DO - 10.1007/s12178-021-09697-5

M3 - Review

C2 - 33689149

VL - 14

SP - 107

EP - 129

JO - Current reviews in musculoskeletal medicine

JF - Current reviews in musculoskeletal medicine

SN - 1935-973X

IS - 2

ER -