Therapeutic exercise for adults post-distal radius fracture: An overview of systematic reviews of randomized controlled trials

Introduction Optimizing recovery after a distal radius fracture is a major concern. There continues to be discrepancies in findings on whether therapeutic exercise improves activity and participation by reducing limitations such as pain and range of motion after fracture. The main objective of this overview was to critically appraise the evidence to establish the effectiveness of therapeutic exercise to improve impairment for adults after a distal radius fracture. Methods An overview of systematic reviews was used, which summarizes a number of systematic reviews. PubMed, CINAHL, PEDro, Scopus, Web of Science, and Cochrane Library were searched. Systematic reviews were included in this overview if the study population was adults after a distal radius fracture, and the intervention group was therapeutic exercise. A systematic review was excluded from this overview if it did not include randomized controlled trials, the full text was not published, or if they were scoping or narrative reviews. The outcomes evaluated were pain, function/disability, range of motion, and strength. Results Five systematic reviews were included in this overview, with between 7 and 26 randomized controlled trials included in the SRs. The overall quality of the reviews was low with two systematic reviews rated as low quality and three rated as critically low quality on the AMSTAR 2 assessment tool. Conclusion The quality of reviews was low, with high risk of bias. All reviews were inconclusive due to limitations in the number and quality of randomized controlled trials. Due to the low quality of evidence, it remains unclear what the effectiveness of exercise is to improve impairments after a distal radius fracture.