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this study will be conducted to investigate the effect of instrument assisted soft tissue mobilization on hand post surgical scars in primary flexor tendons repair in zone v
The hand plays an important role in independent daily living and in communication with the environment. As the most mobile part of the upper extremity, the hand is actively used in everyday life and professional fields. The flexor tendons of the hand are critical for normal hand function. Injury to these tendons can result in absent finger and wrist flexion, and a subsequent loss of overall hand function. The surgical techniques used to repair these tendons have improved in the past few decades, as have the postoperative rehabilitation protocols. In spite of these advances, flexor tendon repairs continue to be plagued by postoperative scar formation, which limits tendon gliding and prevents a full functional recovery. Many different treatment methods can reduce the trauma and surgical scars. Manual scar treatment is one of these methods. Manual scar therapy to be effective requires applying physiological stimuli adequately to the phase of wound healing. Scar tissue therapy is a treatment for reducing pain and functional limitations, improving pliability, reducing hyper-pigmentation, pruritus, fascial adhesions, to reduce scar thickness and smooth surface area. Instrument assisted soft tissue mobilization (IASTM) is a soft-tissue treatment technique where an instrument is used to provide a mobilizing stimulus to positively affect scar tissue and myofascial adhesion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Instrument Assisted Soft Tissue Mobilization | Experimental | Twenty-one patients will receive instrument-assisted soft tissue mobilization and traditional therapy three times a week for four weeks. |
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| traditional therapy | Active Comparator | Twenty-one patients will receive traditional therapy three times a week for four weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Instrument Assisted Soft Tissue Mobilization | Other | the treatment will start by disinfect the instrument between patients to avoid transfer of infections. It is recommended to disinfect the instrument with intermediate-level disinfectants (e.g. isopropyl alcohol), then wash it with soap and water to remove any residuals of the chemical disinfectant off the instrument. If the tools contacts blood, bodily fluids, mucous membranes, or non-intact skin then disinfecting it with high-level disinfectant should be done .IASTM will be done at 30-60 degrees angle for 40-120 seconds+ radiational therapy |
| Measure | Description | Time Frame |
|---|---|---|
| scar assessment | Patient and Observer Scar Assessment Scale (POSAS) will be used to assess scar.It consists of two distinct scales: the OSAS and the PSAS. The PSAS consists of six items: scar-related pain, itchiness, colour, stiffness, thickness and irregularity. Each POSAS item has a 10-point scoring system, with 1 representing normal skin and 10 the worst imaginable scar or sensation; these items are summed to obtain a total score ranging from 6 to 60 for each scale. In addition to the POSAS score, both observer and patient give their own overall opinion on the appearance of the scar using a 10-point scale. | up to four weeks |
| Measure | Description | Time Frame |
|---|---|---|
| range of motion | the range of motion (wrist, metacarpophalangeal, proximal and disatal interphalangeal joint)will be assessed by kinovea software.Kinovea provides a tool to manually draw lines and measure angles to assess ROM as the following:Pause the video at the point where maximum movement occurs (e.g., maximum wrist flexion).Use the angle tool to draw two lines corresponding to the bones of the joint. The software will calculate the angle between the lines, giving you a measure of the ROM. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| alzahraa labib, master | Contact | 01010602832 | zhraalabib214@yahoo.com |
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| ID | Term |
|---|---|
| D006230 | Hand Injuries |
| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
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instrumented assisted soft tissue mobilization and tradional therapy
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opaque sealed envelope
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| traditional therapy | Other | the patients will receive traditional therapy in the form of ultrasound, scar massage, and stretching exercises. |
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| up to four weeks |
| handgrip strength | The hand dynamometer will be used to assess hand grip strength.The subject grips the dynamometer with their maximum force for a few seconds (typically 3 to 5 seconds).Avoid jerky movements or changes in posture during the measurement. | up to four weeks |