Effect of Myofascial Release on Pain, Grip Strength, Manual Dexterity, and Quality of Life in Late-Term Rehabilitation of Hand Flexor Tendon Repairs

NCT ID: NCT07233369

Last Updated: 2025-11-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-11-30

Study Completion Date

2026-04-01

Brief Summary

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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.

Detailed Description

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The hand is the organ we use most in our daily activities, sports activities, expressing ourselves, and performing our jobs. Flexor tendon injuries are among the most common injuries to the hand. The incidence of flexor tendon injuries is estimated at 7-14 per 100,000 people. The flexor tendon can be injured by a blunt or sharp instrument, crushed, or torn by avulsion. It is difficult for tendons to heal without surgery after an injury. Because tendons are composed of living cells and connective tissue, healing begins with cells from both inside and outside the tendon when the tendon ends are brought together. However, scar tissue that forms after surgery adheres the repaired tendons to the surrounding area, limiting movement. Therefore, rehabilitation protocols implemented to ensure proper gliding again and postoperative splinting are essential for tendon healing in tendon injuries are crucial. Tendon Rehabilitation Extension block splints should place the wrist in 30 degrees of flexion to reduce tension in flexor tendon repairs and minimize the risk of postoperative tendon rupture, with the metacarpophalangeal joints at 45-70 degrees of flexion and the interphalangeal joints held in near full extension or slight flexion (15 degrees). Sutures are removed two weeks postoperatively. Thanks to advances in biomechanics and clinical research, there is a general understanding that early therapy-guided tendon release is more beneficial than strict immobilization in efforts to achieve maximum functional recovery. Mobilization promotes intrinsic tendon healing, increases tensile strength, and improves tendon glide while reducing adhesion formation. All of this translates to optimized joint motion, fewer flexion contractures, and overall improved functional outcomes. Tendon repair rehabilitation programs are ideally structured to improve overall hand function while facilitating diverse soft tissue injuries. Flexor tendon rehabilitation protocols are broadly divided into three groups: immobilization, early passive mobilization, and early active mobilization. The selection of a rehabilitation protocol should be determined by considering factors such as the patient's age, ability to comply with treatment, and suture strength.

Current techniques in flexor tendon repair have led to advancements in rehabilitation practice, encouraging a shift from passive methods to early, controlled, and more active approaches. Optimal flexor tendon surgery and treatment outcomes depend on a patient-centered protocol rather than a strictly structured protocol.

Individuals aged 18-65 who have suffered a flexor tendon injury and have undergone related surgery, and who have no neurological symptoms in the repaired extremity will be included in the study.

Individuals who have previously undergone hand surgery for any reason other than this injury, who have a comorbid mental, physical, or neurological chronic illness, who have cognitive problems that impede communication, or who have any other problems that impede cooperation will not be included in the study. When we divided the included individuals into two groups, the control group will receive only conventional physiotherapy, while the study group will additionally receive myofascial release exercises. Pre- and post-treatment evaluations will be conducted. The aim of our randomized controlled trial was to investigate the effects of myofascial release on pain, dexterity, function, and quality of life in the late-stage rehabilitation of hand flexor tendon repairs.

Conditions

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Hand Flexor Tendon Facial Mobilization Exercise

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants were divided in two groups. One group will get intervention. One group will be the control group.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Fascial mobilization group

This group will get a specific programme that combinated with conventional physiotherapy and myofascial release therapy

Group Type EXPERIMENTAL

Fascial mobilization therapy

Intervention Type OTHER

Patients 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.

Control group

This group will get conventional physiotherapy that is include range of motion exercises, electrotherapy and resistance exercise training.

Group Type ACTIVE_COMPARATOR

conventional physiotherapy

Intervention Type OTHER

Conservative 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.

Interventions

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Fascial mobilization therapy

Patients 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.

Intervention Type OTHER

conventional physiotherapy

Conservative 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.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* 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,
* Voluntarily participating in the study.

Exclusion Criteria

* 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.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Hasan Kalyoncu University

OTHER

Sponsor Role lead

Responsible Party

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Tuğba Çevik

physiotherapy

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Tuğba Çevik

Role: PRINCIPAL_INVESTIGATOR

Hasan Kalyoncu University

Locations

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Hasan Kalyoncu University

Gaziantep, Şahinbey, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Central Contacts

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Tuğba Çevik, PT

Role: CONTACT

05345251455

References

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Sheereen FJ, Sarkar B, Sahay P, Shaphe MA, Alghadir AH, Iqbal A, Ali T, Ahmad F. Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel Syndrome. Pain Res Manag. 2022 Jun 8;2022:1975803. doi: 10.1155/2022/1975803. eCollection 2022.

Reference Type RESULT
PMID: 35719196 (View on PubMed)

Yakut Y, Yakut E, Bayar K, Uygur F. Reliability and validity of the Turkish version short-form McGill pain questionnaire in patients with rheumatoid arthritis. Clin Rheumatol. 2007 Jul;26(7):1083-7. doi: 10.1007/s10067-006-0452-6. Epub 2006 Nov 15.

Reference Type RESULT
PMID: 17106618 (View on PubMed)

Ennaciri B, Mahfoud M, El Bardouni A, Berrada MS. Exceptional laceration of flexor digitorum tendons proximal to a severe palmar hand wound: a case report with literature review. Pan Afr Med J. 2015 Nov 20;22:266. doi: 10.11604/pamj.2015.22.266.7495. eCollection 2015.

Reference Type RESULT
PMID: 26958129 (View on PubMed)

Mattar TG, Junior RM, Cho AB, Paula EJ, Rezende MR. COMPARATIVE STUDY BETWEEN TRADITIONAL TENOLYSES AND WITH INTRAOPERATIVE AWAKENING PERFORMED ON THE FLEXOR OSTEOFIBROUS TUNNEL REGION OF THE HANDS (ZONE 2). Rev Bras Ortop. 2015 Dec 8;44(4):324-9. doi: 10.1016/S2255-4971(15)30161-0. eCollection 2009 Jan.

Reference Type RESULT
PMID: 27022514 (View on PubMed)

Quadlbauer S, Pezzei Ch, Jurkowitsch J, Reb P, Beer T, Leixnering M. Early Passive Movement in flexor tendon injuries of the hand. Arch Orthop Trauma Surg. 2016 Feb;136(2):285-93. doi: 10.1007/s00402-015-2362-z. Epub 2015 Dec 11.

Reference Type RESULT
PMID: 26659831 (View on PubMed)

Watanabe K, Ota H, Sasaki H. Eight-strand Cross-locked Cruciate Flexor Tendon Repair Using Double-stranded Suture: A Description of the Surgical Technique. Plast Reconstr Surg Glob Open. 2016 Nov 7;4(11):e1048. doi: 10.1097/GOX.0000000000001048. eCollection 2016 Nov.

Reference Type RESULT
PMID: 27975005 (View on PubMed)

Stevens KA, Caruso JC, Fallahi AKM, Patino JM. Flexor Tendon Lacerations. 2023 Jun 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK493223/

Reference Type RESULT
PMID: 29630275 (View on PubMed)

Ranjan V, Mehta M, Mehta M, Mishra P, Joshi T, Kumar T. The Outcomes of Flexor Tendon Injury Repair of the Hand: A Clinico-Epidemiological Study. Cureus. 2023 Jan 18;15(1):e33912. doi: 10.7759/cureus.33912. eCollection 2023 Jan.

Reference Type RESULT
PMID: 36819329 (View on PubMed)

Moradi A, Menendez ME, Kachooei AR, Isakov A, Ring D. Update of the Quick DASH Questionnaire to Account for Modern Technology. Hand (N Y). 2016 Dec;11(4):403-409. doi: 10.1177/1558944715628006. Epub 2016 Feb 2.

Reference Type RESULT
PMID: 28149205 (View on PubMed)

Other Identifiers

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2025/092

Identifier Type: -

Identifier Source: org_study_id

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