Cross-education after forearm fracture: a randomised controlled trial


Zincirci D. E., Çakır E., Atar S., Uyanık A. F., Demirhan E., KARACAN İ., ...Daha Fazla

Irish Journal of Medical Science, cilt.195, sa.1, ss.167-175, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 195 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1007/s11845-025-04136-7
  • Dergi Adı: Irish Journal of Medical Science
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
  • Sayfa Sayıları: ss.167-175
  • Anahtar Kelimeler: Complex Regional Pain Syndromes, Cross-Education, Distal Radius Fractures, Isokinetic Exercise, Muscle Strength
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objective: This study aimed to examine whether isokinetic exercises applied to the intact wrist could reduce muscle strength loss and prevent the development of Complex Regional Pain Syndrome (CRPS) type I in adults with distal radius fractures. Methods: Forty-two patients with distal radius fractures were randomized into two groups: a Cross-Education (CE) group (n = 21) and a control group (n = 21). Both groups received a standard home exercise program. In addition, the CE group performed 12 supervised sessions of isokinetic wrist strengthening exercises on the non-fractured side during the immobilization period. After cast removal, isometric muscle strength of the fractured wrist was evaluated, and patients were monitored for the development of CRPS type I. Results: The CE group showed significantly higher isometric muscle strength in wrist flexors and extensors compared with the control group (wrist flexors: d = 0.73, p = 0.024; wrist extensors: d = 0.87, p = 0.008). Furthermore, the incidence of CRPS type I was significantly lower in the CE group (p = 0.03). Conclusion: Cross-Education training applied during immobilization can prevent muscle weakness and decrease the risk of CRPS in fracture rehabilitation. Significance: These findings highlight CE as a safe and effective early intervention strategy that may enhance functional outcomes and reduce complications in patients with distal radius fractures.