Distal Radius FractureNCT07913945
One Inch Punch High Impact Training Randomized Control Trial (1'' Punch HIT RCT)
A study testing Standard rehabilitation + one-inch punch training and Standard rehabilitation in people with Distal Radius Fracture, run by The University of Hong Kong at 1 site in Hong Kong.
Trial summary
The goal of this clinical trial is to evaluate whether incorporating high-impact exercise (one-inch punch) into standard rehabilitation improves upper extremity function in adults following volar plating for distal radius fractures. Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Distal Radius Fracture
- What is being tested?
- Standard rehabilitation + one-inch punch training and Standard rehabilitation
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 102 participants
- Where
- 1 siteHong Kong
- Study dates
- 21 Oct 2026to 21 Apr 2029
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adults aged 18-70 years who have undergone volar locking plate fixation for unilateral distal radius fractures
- Surgery performed within 2 weeks of injury
- Ability to commence rehabilitation within 2 weeks post-operatively (consistent with early rehabilitation protocols)
- Willingness to participate and provide informed consent
Who cannot join
- Concomitant tendon, vascular, or nerve injuries
- Associated upper extremity fractures or polytrauma
- Cognitive impairment preventing compliance with rehabilitation protocols
- Pre-existing conditions affecting upper extremity function (e.g., rheumatoid arthritis, neurological disorders)
- Medical contraindications to high-impact exercise
- Severely comminuted fractures, AO/OTA Classification C3/B3 fractures
- Concomitant DRUJ instability, requiring immobilization after operation
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Hong Kong1 site
Queen Mary Hospital
Hong Kong
Colin Yung, MBBS(HK), MMedSci(HK), (852) 2255 4581, colinyung@ortho.hku.hk
About this study
Official title: Randomized Controlled Trial Investigating High-Impact Exercise Using the One-Inch Punch for Distal Radius Fracture Post-Operative Rehabilitation
The goal of this clinical trial is to evaluate whether incorporating high-impact exercise (one-inch punch) into standard rehabilitation improves upper extremity function in adults following volar plating for distal radius fractures. The study will include 102 adult participants who have undergone surgical fixation for unilateral distal radius fractures and will follow them for 12 months post-operatively. The main questions it aims to answer are:
- Does incorporating one-inch punch training lead to better functional outcomes compared to standard rehabilitation alone?
- Does the addition of high-impact exercise enhance recovery metrics such as strength and mobility?
Researchers will compare two groups: one receiving standard rehabilitation plus the one-inch punch exercise, and the other receiving standard rehabilitation only. Participants will perform their assigned exercises over 6 weeks, with both groups undergoing similar physiotherapy and occupational therapy sessions. The experimental group will incorporate punching exercises targeting a cushioned pad starting from post-operative week 3, while the control group will follow the standard rehabilitation protocol without the high-impact exercise.
Read the detailed description
This is a single-center, assessor-blinded, randomized controlled study designed to determine whether the incorporation of high-impact exercise (one-inch punch) into standard rehabilitation following volar plating for distal radius fractures results in superior upper extremity function compared to standard rehabilitation alone.
The study will enroll 102 adult subjects who have undergone volar locking plate fixation for unilateral distal radius fractures, and will be follow-up for 12 months post-operatively. Participants will be allocated in a 1:1 ratio to either the experimental group (standard rehabilitation + one-inch punch training) or the control group (standard rehabilitation only) using computer-generated randomization with concealed allocation.
The Control group and the Intervention group will both receive 6 weeks of standardized home exercise program with instructions provided, including active mobilization exercises, followed by passive mobilization and strengthening.
The Control group will receive standard rehabilitation. Standard rehabilitation consists of four rehabilitation sessions every week, consisting of two physiotherapy sessions and two occupational therapy sessions. Strengthening and passive mobilization exercises will be performed post-operatively under physiotherapist and occupational therapist guidance and assistance.
The Experimental group will receive standard rehabilitation, with one-inch punching exercise incorporated. During each session, participants will perform punching exercise with their operated hand targeting a cushioned pad. Post-operatively, the medical officer will instruct participants on the one-inch punch technique on the orthopaedic ward. Participants will perform the punching exercise with the operated hand directed at a cushioned pad and will commence the one-inch punch training from post-op week 3.
- Conditions
- Distal Radius Fracture
- Being tested
- Standard rehabilitation + one-inch punch training, Standard rehabilitation
- Keywords
- Distal radius fracture, Orthopaedic fracture repair, Rehabilitation, Physiotherapy, Occupational therapy, Patient outcomes
- Medical subject headings
- Wrist Fractures
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Standard rehabilitation + one-inch punch trainingOther
Patients in the experimental group will undergo active and passive exercises as well as one-inch punch training after their initial assessment by rehabilitation therapists at 3-4 weeks after their discharge. One-inch punch training will be encouraged after initial training by rehabilitation therapists and doctors during follow-up clinic at 3-4 weeks after discharge. The intensity of the one-inch punch training will increase gradually under the supervision of the rehabilitation therapists and doctors until the post-operative 9-12-week period
Standard rehabilitationOther
Patients are instructed for active flexion, extension, supination, pronation and finger flexion of the operated wrist along with motion of the shoulder and elbow after operation. Active mobilization is continued for the initial post-operative 6 weeks with allied health therapists. Passive mobilization and strengthening is started at the post-operative 8-10-week period.
| Study group | Role | What they receive |
|---|---|---|
| Experimental group | Experimental | Introduce high-impact exercise (one-inch punch training) into standard rehabilitation after their initial assessment by rehabilitation therapists at 3-4 weeks after their discharge, and gradually increase training intensity until post-operative 9-12 weeks. Receives: Other: Standard rehabilitation + one-inch punch training |
| Control group | Active comparator | Active mobilization is continued for the initial post-operative 6 weeks with allied health therapists, while passive mobilization and strengthening are started at the post-operative 8-10-week period. Receives: Other: Standard rehabilitation |
What is being measured
The primary outcome is the main question the study is designed to answer.
Region-specific patient-reported functional outcome score
Physical function and symptoms measured by the Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH), an 11-item patient-reported measure with a total score ranging from 0 (no disability) to 100 (most severe disability).
Measured: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Health-related Quality of Life Measured by SF-12 Chinese (HK) Version
12-item Short Form Health Survey (SF-12), a patient-reported outcome measure of HRQOL comprised of a mental component (MCS) and physical component (PCS), each with a final score ranging from 0 (worst outcome) to 100 (best outcome).
Measured: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Secondary outcomes (7)
Grip strength
Grip strength will be measured using an electronic dynamometer
Measured: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Range of motion
The patient's wrist range of motion, including pronation, supination, flexion, extension, and radial/ulnar deviation, will be measured.
Measured: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Radiographic outcomes
Patients' X-rays will be assessed for fracture healing, implant migration, and fracture displacement.
Measured: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Numeric Pain Rating Scale (NPRS)
A standard 11-point patient-reported measure used to measure pain intensity from 0 (no pain) to 10 (extreme pain).
Measured: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Peak striking force
The peak striking force of the patient's punch will be measured using a force plate.
Measured: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Incidence of complications
Incidence of wound breakdown, infection, CRPS, tendon irritation, implant failure including screw breakage, and re-operation
Measured: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Qualitative self-reported compliance
Patients' self-reported score on their compliance with the rehabilitation sessions and home exercise based on a Likert Scale of 1 (Did not follow) to 5 (Fully comply)
Measured: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Nov 2026
- Study start21 Oct 2026 (estimated)
- Primary completion21 Oct 2028 (estimated)
- Study completion21 Apr 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Distal Radius FractureStudies of the same condition, open and under way.
- More trials run by The University of Hong KongThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Assessor-blinded, randomized controlled trial design with 102 subjects in two parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 102 participants (estimated)
Sponsor and investigators
- Lead sponsor
- The University of Hong Kong
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Prof. Christian Xinshuo Fang, The University of Hong Kong
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07913945
- Sponsor's protocol ID
- UW 26-431
- Status last verified
- Oct 2026
- First submitted
- 27 Oct 2026
- Last updated
- 3 Nov 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Anonymized dataset to be included as supplementary data in the final publication
Publications
Chan AW, Tetzlaff JM, Gotzsche PC, Altman DG, Mann H, Berlin JA, Dickersin K, Hrobjartsson A, Schulz KF, Parulekar WR, Krleza-Jeric K, Laupacis A, Moher D. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013 Jan 8;346:e7586. doi: 10.1136/bmj.e7586.
PubMed 23303884Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996 Mar;34(3):220-33. doi: 10.1097/00005650-199603000-00003.
PubMed 8628042Sorensen AA, Howard D, Tan WH, Ketchersid J, Calfee RP. Minimal clinically important differences of 3 patient-rated outcomes instruments. J Hand Surg Am. 2013 Apr;38(4):641-9. doi: 10.1016/j.jhsa.2012.12.032. Epub 2013 Mar 6.
PubMed 23481405Beaton DE, Wright JG, Katz JN; Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am. 2005 May;87(5):1038-46. doi: 10.2106/JBJS.D.02060.
PubMed 15866967Kay S, McMahon M, Stiller K. An advice and exercise program has some benefits over natural recovery after distal radius fracture: a randomised trial. Aust J Physiother. 2008;54(4):253-9. doi: 10.1016/s0004-9514(08)70004-7.
PubMed 19025505Nellans KW, Kowalski E, Chung KC. The epidemiology of distal radius fractures. Hand Clin. 2012 May;28(2):113-25. doi: 10.1016/j.hcl.2012.02.001. Epub 2012 Apr 14.
PubMed 22554654
Study at a glance
From the registry record, last updated by the sponsor on 3 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized Controlled Trial Investigating High-Impact Exercise Using the One-Inch Punch for Distal Radius Fracture Post-Operative Rehabilitation
- ClinicalTrials.gov ID
- NCT07913945
- Acronym / sponsor ID
- UW 26-431
- Conditions
- Distal Radius Fracture
- Keywords
- Distal radius fracture, Orthopaedic fracture repair, Rehabilitation, Physiotherapy, Occupational therapy, Patient outcomes
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 102 participants (estimated)
- Lead sponsor
- The University of Hong KongUniversity, hospital or other
- Study start
- 21 Oct 2026 (estimated)
- Primary completion
- 21 Oct 2028 (estimated)
- Study completion
- 21 Apr 2029 (estimated)
- First posted
- 3 Nov 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to evaluate whether incorporating high-impact exercise (one-inch punch) into standard rehabilitation improves upper extremity function in adults following volar plating for distal radius fractures. The study will include 102 adult participants who have undergone surgical fixation for unilateral distal radius fractures and will follow them for 12 months post-operatively. The main questions it aims to answer are:
- Does incorporating one-inch punch training lead to better functional outcomes compared to standard rehabilitation alone?
- Does the addition of high-impact exercise enhance recovery metrics such as strength and mobility?
Researchers will compare two groups: one receiving standard rehabilitation plus the one-inch punch exercise, and the other receiving standard rehabilitation only. Participants will perform their assigned exercises over 6 weeks, with both groups undergoing similar physiotherapy and occupational therapy sessions. The experimental group will incorporate punching exercises targeting a cushioned pad starting from post-operative week 3, while the control group will follow the standard rehabilitation protocol without the high-impact exercise.
Detailed description
This is a single-center, assessor-blinded, randomized controlled study designed to determine whether the incorporation of high-impact exercise (one-inch punch) into standard rehabilitation following volar plating for distal radius fractures results in superior upper extremity function compared to standard rehabilitation alone.
The study will enroll 102 adult subjects who have undergone volar locking plate fixation for unilateral distal radius fractures, and will be follow-up for 12 months post-operatively. Participants will be allocated in a 1:1 ratio to either the experimental group (standard rehabilitation + one-inch punch training) or the control group (standard rehabilitation only) using computer-generated randomization with concealed allocation.
The Control group and the Intervention group will both receive 6 weeks of standardized home exercise program with instructions provided, including active mobilization exercises, followed by passive mobilization and strengthening.
The Control group will receive standard rehabilitation. Standard rehabilitation consists of four rehabilitation sessions every week, consisting of two physiotherapy sessions and two occupational therapy sessions. Strengthening and passive mobilization exercises will be performed post-operatively under physiotherapist and occupational therapist guidance and assistance.
The Experimental group will receive standard rehabilitation, with one-inch punching exercise incorporated. During each session, participants will perform punching exercise with their operated hand targeting a cushioned pad. Post-operatively, the medical officer will instruct participants on the one-inch punch technique on the orthopaedic ward. Participants will perform the punching exercise with the operated hand directed at a cushioned pad and will commence the one-inch punch training from post-op week 3.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Assessor-blinded, randomized controlled trial design with 102 subjects in two parallel groups
| Arm | Type | Receives |
|---|---|---|
| Experimental group | Experimental | Other: Standard rehabilitation + one-inch punch trainingIntroduce high-impact exercise (one-inch punch training) into standard rehabilitation after their initial assessment by rehabilitation therapists at 3-4 weeks after their discharge, and gradually increase training intensity until post-operative 9-12 weeks. |
| Control group | Active comparator | Other: Standard rehabilitationActive mobilization is continued for the initial post-operative 6 weeks with allied health therapists, while passive mobilization and strengthening are started at the post-operative 8-10-week period. |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Adults aged 18-70 years who have undergone volar locking plate fixation for unilateral distal radius fractures
- Surgery performed within 2 weeks of injury
- Ability to commence rehabilitation within 2 weeks post-operatively (consistent with early rehabilitation protocols)
- Willingness to participate and provide informed consent
Key exclusion criteria (7 listed)
- Concomitant tendon, vascular, or nerve injuries
- Associated upper extremity fractures or polytrauma
- Cognitive impairment preventing compliance with rehabilitation protocols
- Pre-existing conditions affecting upper extremity function (e.g., rheumatoid arthritis, neurological disorders)
- Medical contraindications to high-impact exercise
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Standard rehabilitation + one-inch punch trainingPatients in the experimental group will undergo active and passive exercises as well as one-inch punch training after their initial assessment by rehabilitation therapists at 3-4 weeks after their discharge. One-inch punch training will be encouraged after initial training by rehabilitation therapists and doctors during follow-up clinic at 3-4 weeks after discharge. The intensity of the one-inch punch training will increase gradually under the supervision of the rehabilitation therapists and doctors until the post-operative 9-12-week period | Other | Experimental group |
| Standard rehabilitationPatients are instructed for active flexion, extension, supination, pronation and finger flexion of the operated wrist along with motion of the shoulder and elbow after operation. Active mobilization is continued for the initial post-operative 6 weeks with allied health therapists. Passive mobilization and strengthening is started at the post-operative 8-10-week period. | Other | Control group |
Primary outcome
Region-specific patient-reported functional outcome score
Time frame: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Physical function and symptoms measured by the Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH), an 11-item patient-reported measure with a total score ranging from 0 (no disability) to 100 (most severe disability).
Health-related Quality of Life Measured by SF-12 Chinese (HK) Version
Time frame: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
12-item Short Form Health Survey (SF-12), a patient-reported outcome measure of HRQOL comprised of a mental component (MCS) and physical component (PCS), each with a final score ranging from 0 (worst outcome) to 100 (best outcome).
7 secondary outcomes
Grip strength
Time frame: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Range of motion
Time frame: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Radiographic outcomes
Time frame: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Numeric Pain Rating Scale (NPRS)
Time frame: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Peak striking force
Time frame: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Incidence of complications
Time frame: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Qualitative self-reported compliance
Time frame: At post-op 6 weeks, 12 weeks, 6 months, and 12 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Nov 2026.
- Background: PubMed 23303884Chan AW, Tetzlaff JM, Gotzsche PC, Altman DG, Mann H, Berlin JA, Dickersin K, Hrobjartsson A, Schulz KF, Parulekar WR, Krleza-Jeric K, Laupacis A, Moher D. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013 Jan 8;346:e7586. doi: 10.1136/bmj.e7586.
- Background: PubMed 8628042Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996 Mar;34(3):220-33. doi: 10.1097/00005650-199603000-00003.
- Background: PubMed 23481405Sorensen AA, Howard D, Tan WH, Ketchersid J, Calfee RP. Minimal clinically important differences of 3 patient-rated outcomes instruments. J Hand Surg Am. 2013 Apr;38(4):641-9. doi: 10.1016/j.jhsa.2012.12.032. Epub 2013 Mar 6.
- Background: PubMed 15866967Beaton DE, Wright JG, Katz JN; Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am. 2005 May;87(5):1038-46. doi: 10.2106/JBJS.D.02060.
- Background: PubMed 19025505Kay S, McMahon M, Stiller K. An advice and exercise program has some benefits over natural recovery after distal radius fracture: a randomised trial. Aust J Physiother. 2008;54(4):253-9. doi: 10.1016/s0004-9514(08)70004-7.
- Background: PubMed 22554654Nellans KW, Kowalski E, Chung KC. The epidemiology of distal radius fractures. Hand Clin. 2012 May;28(2):113-25. doi: 10.1016/j.hcl.2012.02.001. Epub 2012 Apr 14.
- Individual participant dataSharing planned: Yes. Anonymized dataset to be included as supplementary data in the final publication
Related trials for Distal Radius Fracture
Recruiting
Wrist Injury Strengthening Exercise (WISE) Versus Usual Care Advice for Improving Pain and Function
Distal Radius Fracture, Colles Fracture
Not yet recruiting
Magnesium Alloy Scaffold With Controlled Degradation for Periarticular Bone Defects
Periarticular Bone Defect, Proximal Humerus Fracture
RecruitingPhase 1
Impact of Early ADL Education on Outcomes Post DRF ORIF
Distal Radius Fractures
Recruiting
Optimal Duration of Longitudinal Mechanical Traction in Displaced Radius Fractures: a Prospective Non-inferiority Study
Distal Radius Fracture
Recruiting
Home-Based Photobiomodulation Effects in the Postoperative Period of Distal Radius Fractures
Distal Radius Fracture
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Standard rehabilitation + one-inch punch training and Standard rehabilitation in people with Distal Radius Fracture, run by The University of Hong Kong at 1 site in Hong Kong.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 3 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Colin Yung, MBBS(HK), MMedSci(HK) ((852) 2255 4581, colinyung@ortho.hku.hk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Region-specific patient-reported functional outcome score (time frame: At post-op 6 weeks, 12 weeks, 6 months, and 12 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07913945, which also lists 6 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Nov 2026.