Home-Based Photobiomodulation Effects in the Postoperative Period of Distal Radius Fractures: A Double-Blind, Randomized, Controlled Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 42
- 试验地点
- 1
- 主要终点
- Quick-DASH functional scale - 2 weeks
研究概览
简要总结
This double-blind, randomized controlled clinical trial aims to evaluate the adjuvant effect of home-based photobiomodulation (PBM) therapy on the rehabilitation of surgically treated DRFs combined with an unsupervised home exercise program. A total of 42 participants will be randomly allocated into two groups. The Control Group will undergo the standard surgical procedure, perform the prescribed home exercises recommended by the hospital service, and use an inactive LED plate (photobiomodulation device). The PBM Group will follow the same surgical and exercise protocols but will use an active PBM device. Home exercises will begin 24 hours after surgery and should be performed twice daily for a total of 12 weeks. The device will be applied once daily to the wrist for 12 minutes (6 minutes on the dorsal side and 6 minutes on the palmar side). The primary outcome will be functional wrist assessment using the QuickDASH (Quick Disabilities of the Arm, Shoulder, and Hand) questionnaire at 2 weeks. Secondary outcomes will include wrist range of motion, grip strength, wrist function, and pain (assessed using the PRWE-BR instrument), as well as fracture healing. Assessments will be performed at 2, 4, 6, and 12 weeks post-surgery, except for bone consolidation (assessed starting at week 4) and for pain and range of motion, which will also be evaluated at 24 hours.
详细描述
Distal radius fracture (DRF) is one of the most common fractures in adults. Its treatment can be either conservative or surgical; however, regardless of the treatment method, it is often associated with pain, loss of function and grip strength, joint stiffness, prolonged absence from work, and even loss of fracture reduction. This double-blind, randomized controlled clinical trial aims to evaluate the adjuvant effect of home-based photobiomodulation (PBM) therapy on the rehabilitation of surgically treated DRFs combined with an unsupervised home exercise program. A total of 42 participants will be randomly allocated into two groups (1:1 ratio). The Control Group will undergo the standard surgical procedure, perform the prescribed home exercises recommended by the hospital service, and use an inactive LED plate (photobiomodulation device). The PBM Group will follow the same surgical and exercise protocols but will use an active PBM device. Home exercises will begin 24 hours after surgery and should be performed twice daily for a total of 12 weeks. The LED plate will contain 100 light-emitting diodes, distributed as follows: 18 LEDs at 630 nm (23 mW; 117 J/cm²; 8 J per LED); 18 LEDs at 680 nm (20 mW; 102 J/cm²; 7 J per LED); 32 LEDs at 760 nm (24 mW; 122 J/cm²; 9 J per LED); and 32 LEDs at 830 nm (28 mW; 143 J/cm²; 10 J per LED). The device will be applied once daily to the wrist for 12 minutes (6 minutes on the dorsal side and 6 minutes on the palmar side). The primary outcome will be functional wrist assessment using the QuickDASH (Quick Disabilities of the Arm, Shoulder, and Hand) questionnaire at two weeks. Secondary outcomes will include wrist range of motion, grip strength, wrist function, and pain (assessed using the PRWE-BR instrument), as well as fracture healing. Participants will be blinded to their group allocation and will be evaluated by four researchers who are also blinded to the allocation. Assessments will be performed at 2, 4, 6, and 12 weeks post-surgery, except for bone consolidation (assessed starting at week 4) and for pain and range of motion, which will also be evaluated at 24 hours. In addition to these scheduled assessments, each participant will be followed up with daily phone contact. All collected data will be stored and organized in a secure repository, and appropriate statistical tests will be applied for each specific analysis. A significance level of 5% will be adopted for all tests.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
盲法说明
入排标准
- 年龄范围
- 18 Years 至 65 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Adults aged 18 to 65 years,
- •Both sexes,
- •Patients with isolated, closed distal radius fractures with displacement and surgical indication,
- •Surgical indication defined by instability criteria:
- •Dorsal tilt of the distal fragment >20°,
- •Radial shortening ≥10 mm,
- •Articular incongruity,
- •Dorsal comminution,
- •Fractures classified as Fernandez types I, II, or III,
- •Fractures classified as AO/OTA types 2R3A2, 2R3A3, 2R3B, or 2R3C (except 2R3C3).
排除标准
- •Previous wrist injuries, sequelae, or motor deficits due to neurological lesions,
- •Pathological fractures,
- •Ipsilateral fractures in other regions of the limb,
- •Neurovascular injury with sensory deficit at the fracture site,
- •Local or systemic contraindications to surgery or postoperative recovery,
- •History of photosensitivity,
- •Neurological and/or psychiatric disorders,
- •Proliferative or infectious skin lesions at the wrist region,
- •Pregnancy,
- •Surgical complications (neurological or vascular injuries, or fracture line extension) - excluded from analysis but reported.
研究组 & 干预措施
Active photobiomodulation
Active photobiomodulation wrist brace containing 100 LEDs
- 18 LEDs at 630 nm (23 mW; 117 J/cm²; 8 J per LED)
- 18 LEDs at 680 nm (20 mW; 102 J/cm²; 7 J per LED)
- 32 LEDs at 760 nm (24 mW; 122 J/cm²; 9 J per LED)
- 32 LEDs at 830 nm (28 mW; 143 J/cm²; 10 J per LED)
干预措施: Open reduction and internal fixation (ORIF) with locked volar plate (Procedure)
Active photobiomodulation
Active photobiomodulation wrist brace containing 100 LEDs
- 18 LEDs at 630 nm (23 mW; 117 J/cm²; 8 J per LED)
- 18 LEDs at 680 nm (20 mW; 102 J/cm²; 7 J per LED)
- 32 LEDs at 760 nm (24 mW; 122 J/cm²; 9 J per LED)
- 32 LEDs at 830 nm (28 mW; 143 J/cm²; 10 J per LED)
干预措施: Home exercises (Procedure)
Active photobiomodulation
Active photobiomodulation wrist brace containing 100 LEDs
- 18 LEDs at 630 nm (23 mW; 117 J/cm²; 8 J per LED)
- 18 LEDs at 680 nm (20 mW; 102 J/cm²; 7 J per LED)
- 32 LEDs at 760 nm (24 mW; 122 J/cm²; 9 J per LED)
- 32 LEDs at 830 nm (28 mW; 143 J/cm²; 10 J per LED)
干预措施: Active photobiomodulation (Device)
Inactive photobiomodulation
Inactive LED wrist plate, identical in appearance and sound but without active LEDs
干预措施: Open reduction and internal fixation (ORIF) with locked volar plate (Procedure)
Inactive photobiomodulation
Inactive LED wrist plate, identical in appearance and sound but without active LEDs
干预措施: Home exercises (Procedure)
Inactive photobiomodulation
Inactive LED wrist plate, identical in appearance and sound but without active LEDs
干预措施: Inactive photobiomodulation (Device)
结局指标
主要结局
Quick-DASH functional scale - 2 weeks
时间窗: up to 2 weeks
In this project, the disability/symptom component of the QuickDASH (Disabilities of the Arm, Shoulder and Hand) score, validated for Brazil and available online (https://dash.iwh.on.ca/sites/dash/public/translations/Scoring\_QuickDASH\_Portuguese\_Brazil.pdf ), will be used as presented in Appendix 2. The calculation of the Disability/Symptom Score will follow the official instructions provided by the developers. At least 10 of the 11 items must be answered, and each item has a maximum value of 5. The total score is then transformed to a 0-100 scale by subtracting 1 from the mean of the responses and multiplying the result by 25, a procedure that allows comparison with other scales standardized on a 0-100 range. In this context, higher scores indicate greater disability, and the QuickDASH score is therefore expressed according to the following formula: \[(Sum of responses / n) -1\] X 25, where n: number of questions answered
次要结局
- Quick-DASH functional scale - 4 weeks(up to 4 weeks)
- Quick-DASH functional scale - 6 weeks(up to 6 weeks)
- Quick-DASH functional scale - 12 weeks(up to 12 weeks)
- Pain - 24 hours(up to 24 hours)
- Pain - 2 weeks(up to 2 weeks)
- Pain - 4 weeks(up to 4 weeks)
- Pain - 6 weeks(up to 6 weeks)
- Pain - 12 weeks(up to 12 weeks)
- Analgesic consumption - 2 weeks(up to 2 weeks)
- Analgesic consumption - 4 weeks(up to 4 weeks)
- Analgesic consumption - 6 weeks(up to 6 weeks)
- Analgesic consumption - 12 weeks(up to 12 weeks)
- PRWE-BR Questionnaire - Pain and Disability - 2 weeks(up to 2 weeks)
- PRWE-BR Questionnaire - Pain and Disability - 4 weeks(up to 4 weeks)
- PRWE-BR Questionnaire - Pain and Disability - 6 weeks(up to 6 weeks)
- PRWE-BR Questionnaire - Pain and Disability - 12 weeks(up to 12 weeks)
- Range of Motion -24 hours(up to 24 hours)
- Range of Motion - 2 weeks(up to 2 weeks)
- Range of Motion - 4 weeks(up to 4 weeks)
- Range of Motion - 6 weeks(up to 6 weeks)
- Range of Motion - 12 weeks(up to 12 weeks)
- Grip Strength - 2 weeks(up to 12 weeks)
- Grip Strength - 4 weeks(up to 4 weeks)
- Grip Strength - 6 weeks(up to 6 weeks)
- Grip Strength - 12 weeks(up to 12 weeks)
- Fracture Healing- 4 weeks(up to 4 weeks)
- Fracture Healing- 6 weeks(up to 6 weeks)
- Fracture Healing- 12 weeks(up to 12 weeks)
- Costs Related to Procedures(up to 12 weeks)
研究者
Kristianne Porta Santos Fernandes
PhD
University of Nove de Julho
