Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic.

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Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review Andrea M Bruder, Nora Shields, Karen J Dodd, Nicholas F Taylor Journal of Physiotherapy Volume 63, Issue 4, Pages 205-220 (October 2017) DOI: 10.1016/j.jphys.2017.08.009 Copyright © 2017 Australian Physiotherapy Association Terms and Conditions

Figure 1 Flow of studies through the review. aOne article reported follow-up data from a study that was already included. Journal of Physiotherapy 2017 63, 205-220DOI: (10.1016/j.jphys.2017.08.009) Copyright © 2017 Australian Physiotherapy Association Terms and Conditions

Figure 2 Percentage of included trials achieving each TIDieR item with the description of the experimental group intervention. Journal of Physiotherapy 2017 63, 205-220DOI: (10.1016/j.jphys.2017.08.009) Copyright © 2017 Australian Physiotherapy Association Terms and Conditions

Figure 3 Percentage of included trials achieving each TIDieR item with the description of the control group intervention. Journal of Physiotherapy 2017 63, 205-220DOI: (10.1016/j.jphys.2017.08.009) Copyright © 2017 Australian Physiotherapy Association Terms and Conditions

Figure 4 Standardised mean difference (95% CI) of effect of early exercise and mobilisation compared with delayed exercise and immobilisation after proximal humeral fracture. Abd=abduction, Flex=flexion, Phys=physical domain, ROM=range of motion, SF-36=short form 36. Journal of Physiotherapy 2017 63, 205-220DOI: (10.1016/j.jphys.2017.08.009) Copyright © 2017 Australian Physiotherapy Association Terms and Conditions

Figure 5 Standardised mean difference (95% CI) of exercise to the unaffected limb including a home exercise program compared to a home exercise program after distal radius fracture. Ext=extension, Flex=flexion, Fx=fracture, Pro=pronation, PRWE=patient rated wrist evaluation, ROM=range of motion, Sup=supination. Journal of Physiotherapy 2017 63, 205-220DOI: (10.1016/j.jphys.2017.08.009) Copyright © 2017 Australian Physiotherapy Association Terms and Conditions

Figure 6 Standardised mean difference (95% CI) of effect of a therapy program compared to a home exercise program after conservatively managed distal radius fracture. ADL=activities of daily living, Ext=extension, Flex=flexion, ROM=range of motion. Journal of Physiotherapy 2017 63, 205-220DOI: (10.1016/j.jphys.2017.08.009) Copyright © 2017 Australian Physiotherapy Association Terms and Conditions

Figure 7 Standardised mean difference (95%CI) of effect of therapy program on grip strength (kgs) compared with a home exercise program at 12 weeks post distal radius fracture immobilisation. Journal of Physiotherapy 2017 63, 205-220DOI: (10.1016/j.jphys.2017.08.009) Copyright © 2017 Australian Physiotherapy Association Terms and Conditions

Figure 9 Standardised mean difference (95% CI) of effect of a therapy program compared to a home exercise program after surgically managed distal radius fracture. DASH=Disabilities of the Arm, Shoulder and Hand questionnaire, Dev=deviation, Ext=extension, Flex=flexion, Pro=pronation, PRWE=patient-rated wrist evaluation, ROM=range of motion, Sup=supination. Journal of Physiotherapy 2017 63, 205-220DOI: (10.1016/j.jphys.2017.08.009) Copyright © 2017 Australian Physiotherapy Association Terms and Conditions

Figure 10 Standardised mean difference (95%CI) of effect of therapy program on pain compared with a home exercise program at 12 weeks post distal radius fracture. Journal of Physiotherapy 2017 63, 205-220DOI: (10.1016/j.jphys.2017.08.009) Copyright © 2017 Australian Physiotherapy Association Terms and Conditions

Figure 12 Standardised mean difference (95%CI) of effect of therapy program on grip strength (lb) compared with a home exercise program at 12 weeks post distal radius fracture. Journal of Physiotherapy 2017 63, 205-220DOI: (10.1016/j.jphys.2017.08.009) Copyright © 2017 Australian Physiotherapy Association Terms and Conditions

Figure 14 Standardised mean difference (95% CI) of effect of physiotherapy including supervised exercise and a home exercise program compared to a home exercise program after proximal humeral fractures. AROM=active range of motion, PROM=passive range of motion, Sh=shoulder. Journal of Physiotherapy 2017 63, 205-220DOI: (10.1016/j.jphys.2017.08.009) Copyright © 2017 Australian Physiotherapy Association Terms and Conditions

Figure 15 Standardised mean difference (95% CI) of effect of occupational therapy including physiotherapy and supervised exercise compared to physiotherapy including supervised exercises after conservatively managed distal radius fracture. DASH=Disabilities of the Arm, Shoulder and Hand questionnaire, Ext=extension, Flex=flexion, OT=occupational therapy intervention, Pro=pronation, PT=physiotherapy intervention, ROM=range of motion, Sup=supination. Journal of Physiotherapy 2017 63, 205-220DOI: (10.1016/j.jphys.2017.08.009) Copyright © 2017 Australian Physiotherapy Association Terms and Conditions