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

Hasan Kalyoncu University

Status: Not yet enrolling

Conditions: Facial Mobilization; Hand Flexor Tendon; Exercise

Treatments: Other: conventional physiotherapy; Other: Fascial mobilization therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT07233369

2025/092

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 42 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

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.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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42 participants in 2 patient groups

Fascial mobilization group

Experimental group

Description:

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

Treatment:

Other: Fascial mobilization therapy

Control group

Active Comparator group

Description:

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

Treatment:

Other: conventional physiotherapy