Authors (including presenting author) :
HO Wing Tung (1), TANG Ning (2), NG Wai Kit Raymond (2), CHOW Simon Kwoon-Ho (1), CHEUNG Wing-Hoi (1), WONG Ronald Man Yeung (1)
Affiliation :
(1) Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong (2) Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hospital Authority
Introduction :
Fractures of the distal radius occur in 15% of women older than 50 years of age. These fractures are a particular health concern amongst the elderly, who are at risk of fragility fractures, and are associated with long-term functional impairment, pain and a variety of complications. This is a sentinel event as these fractures are associated with 2 to 4 times increased risk of subsequent hip fractures in elderly patients. This is also an important concept because it is well established that these patients have an increased risk of falling. Fall prevention is therefore crucial to decrease further morbidity and mortality.
Objectives :
The objective of this study is to investigate the effect of low-magnitude high frequency vibration (LMHFV) on postural stability and prevention of falls in elderly patients post distal radius fracture.
Methodology :
A randomized controlled trial investigating effect of 6-months of low-magnitude high-frequency vibration (LMHFV) after a distal radius fracture was conducted. 200 patients were recruited and randomized to control or LMHFV group (35Hz, 0.3g peak-to-peak magnitude, displacement of < 0.1mm, 20 min/day, 5 days/week).
Primary outcome was postural stability measured by Biodex Balance System. Secondary outcomes were falls, timed up-and-go test (TUG), quadriceps strength, compliance, adverse events, and quality of life (SF-36 questionnaire).
Result & Outcome :
5 and 6 patients dropped out from control group and LMHFV group respectively. 90% compliance of LMHFV was documented. There was significant improvement with LMHFV compared to control at 6 months for both static and dynamic stability. Falls occurred significantly less in LMHFV group with 7 times compared to 16 times in control group at 6 months (p=0.05). No adverse events were recorded. TUG test (p=0.02), quadriceps muscle strength (p=0.04), and quality of life in general health (p=0.03) and pain (p=0.05) were significantly improved with LMHFV. Distal radius fractures is one of the earliest fragility fracture and early intervention to prevent imminent risk of falls and fractures is crucial. Previous studies have stressed the importance of reducing falls in distal radius fracture elderly patients, and an effective intervention is crucial. LMHFV improved postural stability and decreased falls in our study. The use of LMHFV can be potentially incorporated in our future Fracture Liaison Services. Positive results will provide a large impact in the prevention of secondary fractures and save healthcare costs.
