Skafolunat İnstabilite Tanılı Hastalarda Nöromusküler Elektrik Stimulasyonu ile Kombine Yapılan Egzersiz Eğitiminin Kas Kuvveti, Proprioseptif Duyu, Reaksiyon Zamanı ve Fonksiyonelliğe Etkisi

Abstract

The aim of this study was to investigate the effects of exercise training combined with neuromuscular electrical stimulation (NMES) on muscle strength, proprioceptive sense, reaction time, weight-bearing capacity, and upper extremity functionality in individuals diagnosed with SL instability. This randomised controlled, single-blind study included 30 patients (26 women/4 men) aged 18–50 years. Participants were randomly assigned to either the Exercise Group (EG), which received exercise training alone, or the Neuromuscular Electrical Stimulation Group (NMESG), which received NMES in addition to the exercise programme. The NMES protocol was applied for 60 minutes per week over 8 weeks, 3 days per week, with 15 minutes for each of the extensor carpi radialis longus, extensor carpi radialis brevis, flexor carpi radialis and abductor pollicis longus muscles. All participants maintained a home exercise programme for seven days per week over eight weeks. Assessments included functionality (QuickDASH, PRWHE, MMAYO, Hand20 Questionnaire), pain Visual Analogue Scale (VAS), joint range of motion, weight-bearing capasity, isokinetic peak torque and endurance (Cybex Norm), grip strength, proprioceptive sense, reaction time (BlazePod®) and quality of life (SF-12). Reductions in pain levels were more pronounced in the NMESG group at the 2nd, 4th, and 8th week follow-ups from-ups from baseline (p<0.05). Compared to EG, statistically significant improvements were observed in QuickDASH scores, VAS, weight-bearing capacity, and flexion endurance in NMESG (p < 0.005). Improvements in PRWHE and SF12 scores were greater in NMESG (p>0.05). In conclusion, NMES, when used in conjunction with exercise strategies aimed at improving stability, was shown to support functional improvement in SL instability and may be an effective rehabilitation component.