The Effect of Mulligan Mobilisation and Graded Motor Imagery Therapy on Proprioception in Distal Radius Fractures
Overview
- Phase
- Not Applicable
- Status
- Enrolling By Invitation
- Sponsor
- Istanbul Aydın University
- Enrollment
- 33
- Locations
- 1
- Primary Endpoint
- Tampa Scale of Kinesiophobia (TSK)
Overview
Brief Summary
Distal radius fractures are common in the elderly population and clinical findings after treatment include limitation of joint motion, pain, and muscle weakness. Physical therapy modalities include exercises, physical agents, and manual therapy techniques. The Mulligan Concept-specific mobilization with movement (MWM) technique improves joint movement by reducing pain and is effective in musculoskeletal disorders. Graded motor imagery activates the motor system, increases neuroplasticity, and promotes functional recovery.
It has been observed that proprioception is impaired after distal radius fracture, affecting muscle tone and postural reflexes. Our study will examine proprioception measurements with an electrogonometer (K Force Sens) and universal goniometer and the effectiveness of MWM and progressive motor imagery treatments.
The study is designed as a one-blind randomized study and a total of 33 patients between the ages of 25-65 who were treated with volar plate screws after distal radius fracture will be included. Patients will be randomized as 11 people and one group will be treated with Mulligan Mobilisation in addition to conventional physiotherapy and the other group will be treated with Graded motor imagery techniques in addition to conventional physiotherapy. The control group will receive only conventional physiotherapy.
Clinical Follow-up Form, Proprioception, Kinesiophobia, Hand Grip strength, Muscle strength, Pain, and functional evaluations will be performed 2 times in total, just before the patient starts physical therapy after surgery and at the end of the 6-week treatment.
A goniometer and electrogoniometer will be used to measure proprioception. Visual Analogue Scale (VAS) and algometer will be used to determine the pain assessment. Jamar's hand grip strength meter and Digital Handheld Dynamometer will be used for muscle strength assessment. Tampa Kinesiophobia Scale will be used to measure the level of kinesiophobia. Patient Rated Wrist/Hand Evaluation (PRWHE) will be used to evaluate the functionality of the patients.
Proprioception evaluation in the upper extremity is limited in the literature, and it will be an original study to examine the relationship between the two measurements after distal radius fracture surgery; in addition, it will be the first study to examine graded motor imagery and mulligan Mobilisation in terms of treatment efficacy.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Participant)
Eligibility Criteria
- Ages
- 25 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age between 25 and 65 years
- •Clinical diagnosis of distal radius fracture
- •Indicated for surgical treatment
- •Surgical fixation performed using plate and screw technique
- •Willing and able to provide informed consent and participate in the study
Exclusion Criteria
- •Inability to read or write
- •Presence of additional orthopedic, neurological, or cardiovascular disorders
- •History of surgery involving the ipsilateral upper extremity within the past 6 months
- •Visual or hearing impairment that would interfere with adherence to treatment or study assessments
Outcomes
Primary Outcomes
Tampa Scale of Kinesiophobia (TSK)
Time Frame: From the start of physiotherapy (approximately 6 weeks post-surgery) to the end of the 6-week treatment period.
The Tampa Scale of Kinesiophobia (TSK) is a self-report measure developed to assess the fear of pain related to movement in patients with musculoskeletal pain. It consists of 17 questions designed to measure the fear of movement and re-injury. The scale utilizes a 4-point Likert scoring system (1 = strongly disagree, 4 = strongly agree). The items are grouped into two distinct factors: activity avoidance and somatic focus. The TSK is commonly used in distal radius fracture cases to assess general fear of movement.
Proprioception Assessment (Joint Position Sense)
Time Frame: From the start of physiotherapy (approximately 6 weeks post-surgery) to the end of the 6-week treatment period.
Application in Your Study: In your project, this assessment will be performed using both a universal goniometer and an electrogoniometer (K Force Sens).The patient is asked to memorize a target angle (20 extension) and then actively reproduce it, with the difference between the target angle and the measured angle recorded as the degree of error.
Secondary Outcomes
- Pain Assessment(From the start of physiotherapy (approximately 6 weeks post-surgery) to the end of the 6-week treatment period.)
- Pressure Pain Threshold (PPT)(From the start of physiotherapy (approximately 6 weeks post-surgery) to the end of the 6-week treatment period.)
- Functionality & Disability(From the start of physiotherapy (approximately 6 weeks post-surgery) to the end of the 6-week treatment period.)
- Grip Strength (Gross)(From the start of physiotherapy (approximately 6 weeks post-surgery) to the end of the 6-week treatment period.)
- Specific Muscle Strength(From the start of physiotherapy (approximately 6 weeks post-surgery) to the end of the 6-week treatment period.)
Investigators
Barış CELBEK
Lecturer
Istanbul Aydın University