Effects of Core Stabilization on Hand Trauma Outcomes

Istinye University51 enrolled

Overview

Hand injuries carry a high risk due to the constant demands for use and their complex functionality. These injuries often occur as a result of various incidents, including household accidents, occupational hazards, traffic collisions, and sports activities, and they are particularly common among male workers. The severity of hand injuries varies widely, ranging from simple soft tissue damage to serious tendon and nerve lacerations, as well as fractures. The extent of the injury can significantly affect the recovery process and the likelihood of patients regaining their previous functional abilities.There is a strong connection between hand injuries and their impact on both emotional status and functional capacity. Changes in the hand's appearance and restrictions in daily activities can lead to feelings of helplessness, frustration, and psychological stress. In particular, concerns about returning to work can further exacerbate psychological distress in workers. Core stabilization plays a crucial role in alleviating these negative effects. The core region not only ensures overall body stability but also directly influences hand function. Strengthening and stabilizing the core muscles enhance proper body movement, thereby improving upper extremity efficiency. This physical improvement also contributes to psychological recovery, as the ability to perform daily activities more comfortably enhances self-confidence and overall quality of life. Therefore, core exercises do not only improve functional outcomes but also support psychological well-being. This study will include 51 male patients diagnosed with traumatic hand injuries who meet the inclusion criteria. Assessments will be conducted on joint range of motion, grip strength, joint position sense, reaction time, hand function, activity and participation levels, quality of life, anxiety and depression scales, galvanic skin response, patient satisfaction, and core stability. These evaluations will be performed at two different time points: before rehabilitation and at the end of a six-week rehabilitation program. The study consists of three groups. The first group will participate solely in a standard hand rehabilitation program. The second group will perform supervised core stabilization exercises three times per week in addition to the standard hand rehabilitation program. In the third group, core stabilization exercises will be performed without the supervision of a physiotherapist, with patients following pre-recorded instructional videos alongside the standard rehabilitation program. For all groups, the hand rehabilitation program will take place five days a week for the first three weeks and three days a week for the following three weeks. Patients in the two groups performing core stabilization exercises will be trained in how to activate the transversus abdominis muscle and coordinate their breathing before starting the exercises. The exercises, including warm-up and cool-down phases, will be performed for ten repetitions per session, with each session lasting between 60 and 90 minutes. Additionally, patients will be assigned home exercises from the standard physiotherapy program, and adherence to these exercises will be monitored through checklists. Although the biomechanical relationship between core muscles and hand function has been explained in the literature, no rehabilitation program incorporating core stabilization exercises for hand injuries has been identified. Moreover, no studies have objectively assessed emotional changes following traumatic hand injuries. This study aims to make a significant contribution to the literature by examining the effects of core stabilization on hand function and emotional well-being.

Interventions

Standard Hand Rehabilitation OnlyBEHAVIORAL

Standard Hand Rehabilitation Program will be delivered over a total duration of six weeks. During the first three weeks, the program will be administered five days per week, and during the following three weeks, it will be performed three days per week. The rehabilitation program will include scar tissue massage, passive and active range of motion exercises for the fingers and wrist, sensory re-education, and edema control using retrograde massage and Coban wrapping. Joint mobilization techniques will be applied to the finger and wrist joints, along with tendon gliding and tendon blocking exercises. Strengthening and stretching exercises targeting the hand and wrist muscles will be progressively introduced throughout the program. Functional training and moderate-level activities will be included as tolerated, particularly in the later stages of the program. The intervention will be structured to gradually increase in intensity and complexity across three phases, each lasting two weeks.

Supervised Core Stabilization + Standard Hand RehabilitationBEHAVIORAL

The second group will receive the same six-week Standard Hand Rehabilitation Program as the control group (5 days per week for the first 3 weeks, and 3 days per week for the last 3 weeks). In addition, participants will perform a Supervised Core Stabilization Exercise Program three times per week for six weeks under a physiotherapist's supervision.The exercises will focus on activating the transversus abdominis and coordinating breathing to improve core stability.Each session will include a warm-up, main core exercises, and a cool-down.In weeks 0-2, the program will include diaphragmatic breathing, transversus abdominis activation, curl-ups, and bridging. In weeks 2-4, it will progress to cross arm-leg extensions, side planks, the "hundred" exercise, and single-leg bridging. In weeks 4-6, Swiss ball exercises will be introduced, including weight shifting forward and backward, hip flexion, bridging, and contralateral arm.The program will advance in intensity across three phases.

Unsupervised Core Stabilization + Standard Hand RehabilitationBEHAVIORAL

he third group will receive the same six-week Standard Hand Rehabilitation Program as the control group (5 days/week for 3 weeks, then 3 days/week for 3 weeks). They will also do an Unsupervised Core Stabilization Exercise Program three times a week for six weeks in the same clinic. Exercises will be the same as the supervised group but done alone using videos without a physiotherapist. The exercises will focus on activating the transversus abdominis and coordinating breathing to improve core stability. Each session includes warm-up, main exercises, and cool-down. In weeks 0-2, exercises include diaphragmatic breathing, transversus activation, curl-ups, and bridging. Weeks 2-4 add cross arm-leg extensions, side planks, the "hundred," and single-leg bridging.Weeks 4-6 introduce Swiss ball exercises, including weight shifting forward and backward, hip flexion, bridging, and contralateral arm lifts. The program will advance in intensity across three phases.