The aim of this study was to investigate the effectiveness of myofascial release exercises performed in the late period compared to classical physiotherapy training in individuals with hand flexor tendon repair.
Being between the ages of 18 and 65,
Having a hand flexor tendon injury and subsequent surgery,
Not having a symptom of deterioration in the extremity being cared for,
Having adequate communication skills,
Having had previous hand surgery for any reason other than this injury,
Having a comorbid mental, physical, or neurological chronic illness,
Having cognitive problems that prevent communication,
Having any problem that prevents cooperation.
Parallel
Fascial mobilization therapy
Other interventionPatients in this group will receive training in myofascial release exercises in addition to the exercises in the control group. Similar to the control group, patients in this group will be asked to continue home exercises five times a week for eight weeks after their two-week treatment.The patients in the study group will receive the same treatment, twice a week for 12 weeks, with each session lasting 45 minutes.
conventional physiotherapy
Other interventionConservative treatment methods such as TENS, Hotpack and normal joint range of motion exercises and tendon gliding exercises and streching exercise will be applied twice a week for 12 weeks, with each session lasting 45 minutes.
The pain
Mc Gill Short Form will used to determine the type and severity of the pain. A short form of the McGill Pain Questionnaire (SF-MPQ) has been developed. The main component of the SF-MPQ consists of 15 descriptors (11 sensory; 4 affective) which are rated on an intensity scale as 0 = none, 1 = mild, 2 = moderate or 3 = severe.
Grip strength
A hand dynamometer will be used to measure patients' grip strength. Grip strength is measured with the Jamar hand dynamometer, recommended by the American Association of Hand Therapists (AETD) and whose validity and reliability have been confirmed in numerous studies. This device is considered the gold standard for measuring hand grip strength. Measurements will be taken before and after treatment, and three times, 10 seconds apart. Each measurement will be taken at the same difficulty level. Generally, the average of the three measurements will be taken.
Hand skills
The Nine-Hole Peg test, used to assess manual dexterity, involves patients quickly removing nine wooden pegs from a storage box, placing them in random holes, then collecting them from the holes and returning them to the storage compartment. The time is measured in seconds using a stopwatch, and anything over 20 seconds is considered a "loss of skill."
Short form SF-36 Quality of life
Individuals' quality of life will be assessed using short form 36 (SF-36). SF-36 is a 36-question scale consisting of physical function, physical role, emotional role, pain, vitality, general health, and mental health subscales.
Upper extremity functionality
The Questionnaire for Arm, Shoulder, and Hand Disabilities (Q-DASH) will be used to assess individuals' upper extremity functions. This questionnaire is a self-administered measurement tool with validated validity and reliability in Turkish. The validity and reliability of the Turkish version of the DASH questionnaire (DASH-T) was conducted in Turkey by Düger et al. in 2006. The questionnaire, consisting of 30 questions, assesses the individual's ability to perform functional activities (21 items), pain (5 items), and psychosocial aspects of the disease (4 items). The total score ranges from 0 to 100, with a higher score indicating better outcomes.
Range of Motion
A Universal Goniometer will be used to assess normal range of motion. Measurements will be made regarding shoulder flexion, extension, abduction, adduction, internal and external rotation ranges of motion in three planes of the upper extremity shoulder joint, and the results will be recorded in degrees.
Kinesiophobia
This is the measure we will use to assess patients' fear of movement in our study. This scale, frequently used in the literature, is based on fear avoidance, fear of work-related activities, and fear of movement or re-injury.
Daily living activities
It is a 15-question questionnaire that measures the severity of wrist pain and the level of disability in daily life activities.
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