Washington

Researchers are evaluating how early participation in daily activities affects recovery after surgery for distal radius fractures treated by open reduction and internal fixation. This randomized controlled trial compares two groups to understand if early activity education improves outcomes such as hand function, pain, and fear of movement. The study is sponsored by George Washington University and focuses on adults recovering from wrist surgery. Participants will be randomly assigned to one of two groups. The experimental group will watch a video and receive a handout about performing daily activities safely during recovery, including a QR code to the video. The control group will receive standard postoperative care education through a different video and handout with a QR code. Both groups receive their education during an office visit shortly after surgery. Participants will be assessed at four time points: 1-2 weeks, 5-7 weeks, 8-10 weeks, and 12-14 weeks after surgery. Assessments include questionnaires on hand function, pain, and fear of movement, as well as clinical tests measuring finger motion, grip and pinch strength, and fine motor skills. Data will be collected via tablets or email and recorded in a secure database. All participants will be followed for 14 weeks to track recovery progress and any complications such as nerve issues or tendonitis.

Researchers are evaluating the impact of starting daily activities early after a distal radius fracture treated with a cast. This randomized controlled trial compares two groups to see how early activity affects recovery and function after this type of wrist fracture. The study aims to understand differences in pain, movement, strength, and coordination between patients who receive special instructions for activity and those who receive standard cast care advice. Participants are assigned randomly to either an experimental group or a control group. The experimental group watches a video and receives a handout about how to perform daily activities safely with the injured hand while in a cast, along with cast care information. The control group watches a video and receives a handout focused only on cast care. Data collection occurs at initial evaluation between 0 and 3 weeks, then at 6 weeks, 9 weeks, and 3 months after injury. Throughout the 3-month study, participants provide information on their function, pain levels, and fear of moving the injured limb. Clinical tests such as finger motion, grip and pinch strength, and fine motor coordination are measured. Questionnaires like the Michigan Hand Evaluation, Visual Analog Pain Scale, and Tampa Scale of Kinesiophobia-11 are completed by participants using tablets or email links. Researchers monitor for complications and note if participants receive hand therapy, with all data securely stored and compared to evaluate recovery progress.

Researchers are evaluating the Trauma Resilience and Recovery Program (TRRP) to improve mental health care access for patients after traumatic injury. This randomized controlled trial compares TRRP with enhanced usual care over 12 months to understand its impact on clinical and functional outcomes. The study also focuses on diverse patient groups, including underrepresented minorities and victims of violent trauma, to tailor the care model better. The trial is conducted at George Washington University hospital, which serves a diverse trauma patient population without an existing embedded mental health program. The TRRP is a stepped care model starting with education at the bedside about mental health recovery, risk assessment, and brief intervention for high-risk patients. It then supports symptom self-monitoring and education through automated text messages, followed by screening for PTSD and depression 30 days after injury using a chatbot or telephone. If needed, patients receive referrals and warm handoffs to mental health services. The enhanced usual care group receives education and referral information but without the stepped intervention model. Participants will be assessed at 3, 6, and 12 months after enrollment through clinical interviews and various questionnaires measuring PTSD symptoms, depression, emotional support, pain, sleep disturbance, and other health and social factors. Data from electronic medical records and demographic surveys are collected at baseline. The study includes safety and functional outcome monitoring, with qualitative interviews to identify ways to improve care for diverse patients. Total follow-up lasts one year, with detailed evaluations at multiple timepoints.