The Effect of Diabetes On Functional Outcomes Among Individuals With Distal Radius Fractures
Sana'a A Alsubheena, BScPT MSc; Joy MacDermid, BScPT, MSc, PhD; David Walton, PT PhD; Ruby Grewal, MD, MSc, FRCSC
Western University, London, ON, Canada
This study investigated the effect of diabetes on pain, hand function, physical health status, grip strength, wrist and forearm ROMs among patients with distal radial fractures (DRFs).
A prospective cohort study assessed a total of 479 patients with DRFs. Patients were classified into patients with diabetes and patients without diabetes based on self-report. Patient Rated Wrist Evaluation (PRWE) questionnaire was used to assess pain and hand function. The SF-12 questionnaire assessed physical status. Both questionnaires examined DRFs recovery at baseline, 3-month, and at 1-year. Grip strength and ROMs were measured using N-K hand evaluation system at 3-month and 1-year. Results revealed a significant improvement in PRWE scores over time (69±19 to 25±22; 76±15 to 20±20 for patients with and without diabetes respectively, p < 0.01) with a significant interaction between time and diabetes (p < 0.01); indicating that patients with diabetes recovered more slowly than the rest of the cohort. There was improvement over time on physical status (36±12 to 45±12; 39±9 to 50±9, p <0.01), grip strength (16±7 to 24±10; 15±9 to 24±10, p < 0.01), and ROM [flexion (42±14 to 49±15; 43±15 to 54±14 , p < 0.01), extension (45±11to 52±11; 46±13 to 53±12, p < 0.01), pronation (73±10 to 77±9; 73±11 to 78±9, p < 0.01), and supination (58±17 to 65±14; 61±17 to 70±12, p < 0.01)] for patients with and without diabetes, respectively. Patients with diabetes did not differ significantly in these secondary outcomes than the rest of the cohort. Diabetes is associated with greater pain, hand disability, and slower recovery after DRFs.
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