Article

Pain management is essential in the early stages of the rehabilitation of distal
radius fractures (DRFx).
Pain intensity at the acute stage is considered
important for determining the individual recovery process, given that higher pain
intensity and persistent pain duration negatively affect the function and
cortical activity of pain response. Graded motor imagery (GMI) and its components
are recent pain management strategies, established on a neuroscience basis.
PURPOSE OF THE STUDY: To investigate the effectiveness of GMI in hand function in
patients with DRFx. METHODS: Thirty-six participants were randomly allocated to
either GMI (n = 17; 52.59 [9.8] years) or control (n = 19; 47.16 [10.5] years)
groups. The GMI group received imagery treatment in addition to traditional
rehabilitation, and the control group received traditional rehabilitation for 8
weeks. The assessments included pain at rest and during activity using the visual
analog scale, wrist and forearm active range of motion (ROM) with universal
goniometer, grip strength with the hydraulic dynamometer (Jamar; Bolingbrook,
IL), and upper extremity functional status using the Disability of the Arm,
Shoulder and Hand Questionnaire, and the Michigan Hand Questionnaire. Assessments
were performed twice at baseline and at the end of the eighth week. RESULTS: The
GMI group showed greater improvement in pain intensity (during rest, 2.24;
activity, 6.18 points), wrist ROM (flexion, -40.59; extension, -45.59; radial
deviation, -25.59; and ulnar deviation, -26.77 points) and forearm ROM
(supination, -43.82 points), and functional status (Disability of the Arm,
Shoulder and Hand Questionnaire, 38.00; Michigan Hand Questionnaire, -32.53
points) when compared with the control group (for all, P < .05). CONCLUSION: The
cortical model of pathological pain suggests new strategies established on a
neuroscience basis. These strategies aim to normalize the cortical proprioceptive
representation and reduce pain. One of these recent strategies, GMI appears to
provide beneficial effects to control pain, improve grip strength, and increase
upper extremity functions in patients with DRFx.
CI - Copyright (c) 2017 Hanley & Belfus. Published by Elsevier Inc. All rights
reserved.

Langue : ANGLAIS