Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT06215872 |
| Other study ID # |
BAU-ALKAN-001 |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
June 2, 2021 |
| Est. completion date |
January 10, 2024 |
Study information
| Verified date |
January 2024 |
| Source |
Bahçesehir University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
When determining the treatment method to be applied in distal radius fracture (DRF), in
addition to clinical and radiological evaluation, the patient's age, physical activity level,
cognitive status, severity of trauma, mechanism of injury and type of fracture are important
factors in the treatment plan. Clinical studies show that physiotherapy is useful in
improving the limitation of movement and pain in DRF. It shows that the active movement level
is increased by decreasing the level. Rehabilitation after surgery proceeds similarly to
conservative treatment. When exercise approaches in the literature are examined, it is seen
that specific exercises for the wrist and forearm are recommended for treatment, but it has
been reported that there are not enough studies to constitute evidence value. For decades,
the skeletal muscles of the human body have been characterized as independent structures.
However, recent research supports the "single muscle theory", contrary to this classical
view. According to this theory, the fascia tissue that covers the entire body connects the
muscles to each other in the form of chains, and the muscles in the chain work together in
performing functional movements. These chains are called myofascial chains. Fascia tissue
that creates all these connections; It consists of tightly arranged connective tissue and is
structurally similar to tendons and ligaments. It surrounds organs, muscles, vessels and
nerves, connects tissues and allows them to slide and move over each other. Past histological
studies have reported that there are also contractile cells in the fascia structure. Although
there are problems in rehabilitation after DRF that go beyond a single segment and affect the
whole body; There is no study in the literature that uses the myofascial chain exercises
approach in the treatment of these problems. In the light of all this information, the thesis
study aims to ensure the active participation of the upper body muscles in the rehabilitation
process with the DRUK program planned with myofascial chain exercises and in this way to
improve the functional level obtained as a result of rehabilitation.
Description:
Clinical studies show that physiotherapy is useful in improving the limitation of movement in
distal radius fractures and increases the level of active movement by reducing the level of
pain. Providing functional restoration with physiotherapy not only increases the quality of
life but also reduces the number of days patients cannot go to work. Rehabilitation after
surgery proceeds similarly to conservative treatment. When exercise approaches in the
literature are examined, it is seen that specific exercises for the wrist and forearm are
recommended for treatment, but it has been reported that there are not enough studies to
constitute evidence value. Due to the increased risk of prolonged immobilization and damaged
tissues after surgery compared to closed reduction; If problems such as disuse atrophy, loss
of proprioception and joint range of motion are taken into consideration, all upper extremity
disorders may occur after surgery, including the elbow and shoulder joints, which are
positioned together with the wrist and whose use is restricted. The following have been
reported as early and late complications after surgical treatments: i)Complex regional pain
syndrome, reflex sympathetic dystrophy, algodystrophy, compartment syndrome; ii) Tendon
adhesion or rupture; iii)Nerve compression; iv) Post traumatic arthritis; v)Dupuytren's
contracture. Although some of these complications are related to surgery, other complications
are affected by processes involving the fascial system. For decades, the skeletal muscles of
the human body have been characterized as independent structures. However, recent research
supports the "single muscle theory", contrary to this classical view. According to this
theory, the fascia tissue that covers the entire body connects the muscles to each other in
the form of chains, and the muscles in the chain work together in performing functional
movements. These chains are called myofascial chains. In cadaveric studies, mechanical force
transfer along these connections has been demonstrated, and this connection has been tried to
be explained with biotensegrite models. Due to this load transfer, all structures on the
chain are affected by the forces or disorders that any structure in the myofascial chain is
exposed to, and this is explained by the biotensivity theory. Fascia tissue that creates all
these connections; It consists of tightly arranged connective tissue and is structurally
similar to tendons and ligaments. It surrounds organs, muscles, vessels and nerves, connects
tissues and allows them to slide and move over each other. Past histological studies have
reported that there are also contractile cells in the fascia structure. Although there are
problems in rehabilitation after distal radius fracture that go beyond a single segment and
affect the whole body; There is no study in the literature that uses the myofascial chain
exercises approach in the treatment of these problems. In the light of all this information,
the thesis study aims to ensure the active participation of the upper body muscles in the
rehabilitation process with the distal radius fracture program planned with myofascial chain
exercises and in this way to improve the functional level obtained as a result of
rehabilitation.
