Med. J. Cairo Univ., Vol. 83, No. 2, December: 31-36, 2015 www.medicaljournalofcairouniversity.net The Effect of Burst Mode Alternating Current Versus Axial Load Exercises on Hand Improvement and Grip Strength Post Colles' Fracture EMAD ELDIN M. ABD ELATIEF, M.Sc.*; MAHER A. ELKABALAWY, Ph.D.**; AMIR M. SALEH, Ph.D.** and AHMED L. MOHAMED, M.D.*** The Department of Basic Science, Faculty of Physical Therapy, 6 th of October* and Cairo** Universities and The Department of Orthopedics, Faculty of Medicine, Cairo University*** Abstract Background: Colles' fracture is one of the fractures that affect the lower third of the radius with complications after healing like; pain, and hand stiffness. Objective: This study compared the effects of Burst Mode Alternating Current and closed kinetic chain exercise on pain, functional disability and grip strength post colles' fracture. Methods: Forty-five patients with stable colles' fractures were randomly classified into three groups with fifteen patients in each group; Group I received traditional exercise as; wrist Mobilization, stretching exercises, range of motion exercises (passive and active) and edema control of the wrist joint. Group II stimulated by burst mode alternating current (Russian current) in addition to traditional exercise. Group III received axial load exercises (closed kinetic chain exercise) as; wall press, plyometric wall push up, Quadruped rhythmic stabili- zation, and Push up exercises) plus traditional exercise. All outcome measures including Pain, functional disability and grip strength were evaluated before and after the treatment program by Patient rated wrist evaluation (PRWE) question- naire and hand dynamometer respectively. Results: Showed that group II that received electrical burst mode alternating current had higher statistical significant than Group I and Group III ( p<0.05). Conclusion: The finding of the study revealed that stim- ulation of wrist flexors by burst mode alternating current (Russian current) in addition to a traditional exercise program was more effectivethan exercise alone after colles' fracture. Key Words: Colles' Fracture – Burst mode alternating current – Axial load exercise. Introduction COLLES' fracture is a fracture of the distal radius approximately 2.5 cm proximal to the joint surface of the radius with dorsal (posterior) displacement Correspondence to: Dr. Emad Eldin M. Abd Elatief, The Department of Basic Science, Faculty of Physical Therapy, 6th of October University of wrist and hand. It sometimes referred to as a 'dinner fork' or 'bayonet' deformity due to the shape of the resultant forearm [1] . Colles' fractures are seen in all adult age groups and demographics with a high majority in two distinct populations: younger patients who involved in high impact trauma and elderly patient with osteoporotic bone [2] . Patients with colles' fracture complained of pain, edema, decreased the range of motion, de- creased strength, and decreased functional abilities. The pain becomes worse upon waking in the morn- ing and was marginally relieved by medication [3] . Closed reduction with cast immobilization for about 6 weeks is one of the methods that used for the treatment of stable fracture to allow the fracture to heal without increase incidence of malunion. After removal of the cast and healing of the fracture, the swelling of the hand is present with pain and stiffness in the wrist joint. All these findings affect the physiological and biomechanical function of the hand [4] . Physical therapy plays a significant role in rehabilitation of patient with Colles' fracture whichcan be used several forms of rehabilitation during the treatment process, such as recommen- dations, patient education, and supervised exercise (hospital-based) or home-based active and passive mobilization exercises to facilitate patient func- tional recovery [5] . Axial load exercises refer to closed kinetic chain (CKC) exercises that stimulate joint receptors like Pacinian corpuscle and ruffini's ending recep- tors. The advantages attributed to CKC exercises result from the integration of sensorimotor feedback which reaches the central nervous system from 31