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Immobilization following median and/or ulnar nerve repairs results in strength loss in the wrist and finger extensor muscles. Given the critical importance of wrist extension for functional grip, this condition significantly restricts hand functions. Therefore, this study aims to investigate the effects of EMG-triggered electrical stimulation applied to the wrist and finger extensors, in addition to conventional physiotherapy, on functional outcomes in patients undergoing median and/or ulnar nerve repair, with the objective of restoring extensor muscle weakness induced by immobilization.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EMG-triggered electrical stimulation group | Experimental |
| |
| Conventional physiotherapy group | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| EMG-triggered electrical stimulation | Other | This group will receive EMG-triggered electrical stimulation therapy in addition to conventional physiotherapy in the 5th week.The EMG-triggered electrical stimulation protocol will be conducted over 12 sessions (3 days/week for 4 weeks). Surface electrodes will be placed parallel to the fibers of the wrist and finger extensors-specifically the EDC, ECRL/B, and ECU-using anatomical landmarks and palpation. Following a baseline calibration (5s contraction/10s rest) to establish a microvolt threshold, the device will require active cognitive participation from the patient to initiate stimulation. Once the threshold is exceeded, stimulation will be delivered at 60 Hz with a 300 µS pulse width and 0.5s ramp times. The procedure involves 10 repetitions per muscle, utilizing a 10s contraction and 30s rest cycle to enhance functional recovery. |
| Measure | Description | Time Frame |
|---|---|---|
| Manual muscle test | At 12 and 24 weeks after surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| Gross and fine grip strength measurements by hand dynamometry and pinch gauge (kg) | At 12 and 24 weeks after surgery. | |
| Assessment of hand function via Michigan Hand Outcomes Questionnaire | The score for each domain and the total score range from min 0 to max 100. For all domains except pain, a higher score denotes better hand performance or satisfaction. For the pain domain, a higher score indicates more pain. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Umut Eraslan | Contact | +905444126520 | ueraslan@pau.edu.tr |
| Name | Affiliation | Role |
|---|---|---|
| Umut Eraslan | Pamukkale University | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16627680 | Background | Baldwin ER, Klakowicz PM, Collins DF. Wide-pulse-width, high-frequency neuromuscular stimulation: implications for functional electrical stimulation. J Appl Physiol (1985). 2006 Jul;101(1):228-40. doi: 10.1152/japplphysiol.00871.2005. Epub 2006 Apr 20. | |
| 18644424 | Background | Shin HK, Cho SH, Jeon HS, Lee YH, Song JC, Jang SH, Lee CH, Kwon YH. Cortical effect and functional recovery by the electromyography-triggered neuromuscular stimulation in chronic stroke patients. Neurosci Lett. 2008 Sep 19;442(3):174-9. doi: 10.1016/j.neulet.2008.07.026. Epub 2008 Jul 15. |
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| ID | Term |
|---|---|
| D059348 | Peripheral Nerve Injuries |
| ID | Term |
|---|---|
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D020196 | Trauma, Nervous System |
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|
| Conventional physiotherapy group | Other | The conventional physiotherapy program will comprise splinting, edema control, range of motion exercises, and resistance training. |
|
| At 12 and 24 weeks after surgery |
| D014947 | Wounds and Injuries |