EFFECTS OF CONCENTRIC EXERCISES WITH AND WITHOUT MULLIGAN WRIST MOBILIZATION ON PAIN, GRIP STRENGTH, RANGE OF MOTION AND FUNCTION AFTER DISTAL RADIUS FRACTURE

Abstract

Background: Distal radius fractures are among the most common orthopedic injuries, often requiring effective rehabilitation strategies to restore function and mobility. Mulligan’s mobilization with movement (MWM) is widely used in musculoskeletal rehabilitation but requires further investigation to understand its effectiveness in improving outcomes following distal radius fractures. This study aimed to evaluate the effects of adding MWM to a conventional concentric exercise regimen on pain, grip strength, range of motion (ROM), and wrist function in patients with distal radius fractures.

Objective: To determine the impact of Mulligan’s mobilization with movement combined with concentric exercises on pain, ROM, grip strength, and wrist function compared to concentric exercises alone in patients with distal radius fractures.

Methods: A single-blinded randomized controlled trial was conducted at DHQ Hospital Sheikhupura. Twenty patients with distal radius fractures were randomly divided into two groups: Group A (n=10) received concentric exercises combined with MWM, and Group B (n=10) received concentric exercises alone. Treatment was administered three times a week for one month. Pain, wrist function, grip strength, and ROM were assessed using the Numeric Pain Rating Scale (NPRS), Patient-Rated Wrist Evaluation (PRWE), dynamometer, and goniometer, respectively. Assessments were conducted pre- and post-intervention. Statistical analysis was performed using SPSS, with significance set at p<0.05.

Results: Group A showed significantly better improvements in all variables except ulnar deviation. NPRS scores improved from 5.40±1.42 to 1.50±0.52 in Group A compared to 6.50±1.35 to 2.50±1.08 in Group B (p<0.05). PRWE scores decreased from 54.6±9.53 to 30.6±7.18 in Group A and from 63.10±14.75 to 44.40±13.85 in Group B (p<0.05). Grip strength increased from 3.30±0.94 to 11.20±1.39 in Group A versus 2.10±0.73 to 4.20±1.22 in Group B (p<0.05). ROM significantly improved in Group A for flexion, extension, radial deviation, pronation, and supination (p<0.05), while ulnar deviation showed no significant difference between groups (p>0.05).

Conclusion: Adding Mulligan’s mobilization with movement to a conventional concentric exercise regimen significantly improved pain reduction, wrist function, grip strength, and most ROM measures compared to concentric exercises alone, except for ulnar deviation. This approach can be an effective rehabilitation strategy for patients with distal radius fractures.