Triangülar fibrokartilaj kompleks yaralanmasında rehabilitasyonun bireylerin ağrı düzeylerine göre değerlendirme parametreleri üzerine etkisinin araştırılması

Abstract

Akar, Z. Investigation of the Effect of Rehabilitation in Triangular Fibrocartilage Complex Injury on the Evaluation Parameters of Individuals According to Pain Levels. Hacettepe University, Graduate School of Health Sciences, Physiotherapy and Rehabilitation Program, Master's Thesis, Ankara, 2023. The aim of this study was to investigate the recovery process in patients with triangular fibrocartilage complex (TFCC) injuries in relation to pain intensity who underwent conservative rehabilitation. Nineteen subjects diagnosed with a TFCC lesion by magnetic resonance imaging were included in the study. Subjects were divided into two groups according to pain intensity: the mild group (n=10) and the severe group (n=9). TFCC-specific assessments included pain, clinical tests, and weight bearing tolerance. TFCC-non specific assessments included joint position sense, functional sensation, grip strength, hand dexterity, functional status, kinesiophobia, and quality of life were included. All assessments were performed 5 times, once every 2 weeks. Patients received a supervised rehabilitation program once a week for 8 weeks. In mild group, clinical tests, hand dexterity and function status improved from week 2, while pain, joint position sense, grip strength and kinesiophobia improved from week 4 (p < 0.05). In severe group, clinical tests, pain, grip strength, hand dexterity, kinesiophobia, functional status and quality of life improved from week 2, while joint position sense and functional sensation improved from week 4. Emotional role limitation, mental health, and vitality improved from week 6 (p < 0.05). Clinical tests, joint position sense, dexterity, and upper extremity function were similar in mild and severe groups (p < 0.05). Pain, grip strength, functional sensation, fear of movement, and quality of life improved more rapidly in severe group (p < 0.05). Targeted minimal improvements in DASH score was achieved by week six. Predictive variables included active pronation pain, ulnocarpal test, weight bearing tolerance test, functional status, and social function. This study presents a follow-up algorithm for patients with TFLC lesions after conservative rehabilitation and makes a unique contribution by examining patient response to rehabilitation in terms of pain intensity, which is a key factor in functional recovery. By evaluating pretreatment variables, it is possible to identify those individuals who are likely to be successful after six weeks of conservative treatment.