Evaluating probable predictors for fall related wrist fracture among the elderly population in a tertiary care hospital, Bhubaneswar

Abstract

Wrist fractures are one among the common injuries of the elderly leading to reduced quality of life and impaired functionality, if not treated and restored adequately. Factors like asymmetry of vestibular function, decreased plantar sensation, unstable posture and functional disability have been more commonly associated with fall related wrist fractures among the geriatric population. Since wrist fractures are considered as an indicator for fracture incidence in the future specially for hip fractures, preventive measures like improving balance, function of the balance system in the inner ear and feeling in people’s feet can be timely adopted which in addition might be helpful in rehabilitation of patients with fractured wrist.To determine effect of multi sensory training (MST) on posture (muscle strength), vestibular function, vibration perception, tactile sensation and functional ability compared to wrist stabilization training (WT) among elderly with fall related wrist fractures.Experimental research design was adopted for the study among the 130 follow up cases of wrist fracture where 88 participants were randomized to Multi Sensory Training and 42 received Wrist stabilization Training. The training period was 12 weeks, with 4 supervised sessions by a physiotherapist and home exercises for both groups. Pre and post training measurements included Head Shake Test (HST), Semmes–Weinstein Monofilaments (SWM), Vibration perception Test, 10m Walk Test (10MWT), Five Times Sit to Stand Test (FTSTS), Activities Specific Balance Confidence (ABC) and Dizziness Handicap Inventory Scales (DHI). FTSTS, ABC, DHI were found to be statistically significant between the 2 groups. In contrast to wrist stabilization training, MST was more helpful in improving HST (p=0.001). Vestibular function among the cases of wrist fracture was better with Multi Sensory Training. It may be applied as a routine training intervention post fracture treatment. A robust sample size can be taken up to generalize its effectiveness.