Dual-Task Resistance Training Improves Strength and Reduces Pain More Than Resistance Exercise Alone in Elbow Fracture Rehabilitation: A Randomized Controlled Trial

Objective: To examine the effects on strength, pain intensity, range of motion (ROM), and functionality of a 12-week dual-task resistance exercise program in patients undergoing rehabilitation from elbow fractures. Design: Randomized controlled trial. Setting: Rehabilitation hospital. Participants: Individuals undergoing elbow fracture rehabilitation (N=32). Intervention: Randomization was performed sequentially using numbered envelopes containing assignments to either an intervention group (dual-task resistance training using a mathematical task with self-regulation, N=18) or a control group (traditional resistance training, N=14) for 12 weeks. Main Outcome Measures: The primary outcomes were muscle strength for elbow flexors and extensors and pain assessed by the visual analog scale from 0 to 100 mm. The secondary outcomes were kinesiophobia assessed by the Tampa Scale-11 and disability using the Disabilities of the Arm, Shoulder, and Hand questionnaire and passive ROM. Results: Dual-task resistance training improved strength and reduced pain more than resistance training alone (P<.05), and only the dual-task group improved in kinesiophobia (P<.05). The linear regression showed a significant negative association between kinesiophobia and increased elbow strength in the dual-task group (flexion, r=−0.53, P=.024; extension, r=−0.65, P=.004) but not in the control group (P>.05). No significant differences were observed between the group for disability and passive ROM (P>.05). Conclusions: Dual-task resistance training and traditional resistance training both enhance strength, reduce pain, improve functionality, and increase ROM after 12 weeks of elbow fracture rehabilitation. However, dual-task resistance training is superior to resistance training alone in enhancing strength and reducing pain.