Raw experimental data.

ObjectiveProlonged immobilization of joints after distal radius fracture (DRF) causes cerebral disuse-dependent plasticity (DDP) and deterioration of upper extremity function. Action observation therapy (AOT) can improve DDP.Trial designThis nonrandomized controlled trial (UMIN 000039973) tested the hypothesis that AOT improves hand-use difficulties during activities of daily living in patients with DRF.MethodRight-handed women with volar locking plate fixation for DRF were divided into AOT and Non-AOT groups for a 12-week intervention. The primary outcome was difficulty in using the fractured hand, assessed with the Japanese version of the Patient-related Wrist Evaluation (PRWE). The secondary outcomes were range of motion (ROM) of the injured side and gap between measured ROM and patient-estimated ROM. The survey was administered immediately post operation and at postoperative weeks 4, 8, and 12. The AOT group used a head-mounted display and three-dimensional video during ROM exercises. The Non-AOT group used active ROM exercises alone. A generalized linear model (GLM) was used to confirm interactions and main effects by group and time period, and multiple comparisons were performed.ResultsThirty-five patients were assigned to the AOT group (n = 18, median age, 74 years) or the Non-AOT group (n = 17, median age, 70 years). In the GLM, PRWE Total, PRWE Specific, and PRWE Usual scores revealed interactions between groups and periods. The post-hoc test revealed that the PRWE Specific scores (z = 3.43, p = 0.02) and PRWE Usual scores (z = 7.53, pz = 3.29, p = 0.04) were lower at 8 weeks postoperatively.ConclusionsThese results suggested that AOT can improve hand-use difficulties in right-handed women after DRF surgery. AOT positively affects the motor imagery of patients with DRF and can reverse the patient’s perceived difficulty in using the fractured hand during rehabilitation.研究目的：桡骨远端骨折（distal radius fracture, DRF）后长期关节制动可诱发脑废用依赖性可塑性（cerebral disuse-dependent plasticity, DDP），并导致上肢功能减退。动作观察疗法（action observation therapy, AOT）可改善脑废用依赖性可塑性。 试验设计：本项非随机对照试验（UMIN 000039973）验证了「动作观察疗法可改善桡骨远端骨折患者日常生活活动中的手部使用困难」这一研究假说。 研究方法：纳入接受掌侧锁定钢板固定术的右利手女性桡骨远端骨折患者，将其分为动作观察疗法组（AOT组）与非动作观察疗法组（Non-AOT组），开展为期12周的干预。主要结局指标为患手使用困难程度，采用日语版患者相关腕部评估量表（Patient-related Wrist Evaluation, PRWE）进行评定。次要结局指标包括患侧关节活动度（range of motion, ROM）以及实测关节活动度与患者自评关节活动度的差值。分别于术后即刻、术后第4、8、12周完成问卷调查。AOT组在关节活动度训练期间使用头显设备与三维视频辅助训练，Non-AOT组仅开展主动关节活动度训练。采用广义线性模型（generalized linear model, GLM）验证组间与时间的交互效应及主效应，并进行多重比较分析。 结果：共35例患者被分配至AOT组（n=18，中位年龄74岁）或Non-AOT组（n=17，中位年龄70岁）。广义线性模型分析显示，PRWE总分、PRWE特异性评分与PRWE日常评分均存在组间与时间的交互效应。事后检验结果表明，术后8周时PRWE特异性评分（z=3.43, P=0.02）与PRWE日常评分（z=7.53, z=3.29, P=0.04）显著降低。 结论：本研究结果提示，动作观察疗法可改善桡骨远端骨折术后右利手女性患者的手部使用困难。动作观察疗法对桡骨远端骨折患者的运动意象具有积极影响，能够逆转康复阶段患者对患侧手部使用的感知困难。