The study will be randomized controlled trial. This study will be conducted at the University of Lahore Teaching Hospital, Lahore, Pakistan. This will investigate the effects of routine physical therapy with and without Kinesio taping in patients with Wrist Joint Hypermobility. A sample size of 38 participants will be randomly assigned into two groups. Group A will receive routine physical therapy protocol, while Group B will receive the same protocol with additional Kinesio taping. The interventions will be delivered three times per week for 8 weeks. Clinical outcomes, including pain, range of motion, and functionality, will be assessed at baseline and after 8 weeks using standardized tools.
Screening: All participants will be screened according to inclusion and exclusion criteria. Eligible individuals will provide written informed consent prior to participation. Randomization \& Allocation: Participants will be randomized into two groups using the lottery method. Blinding: This will be a single-blind study in which the assessor will be blinded to group allocation. Group A (Control): Participants will receive routine physical therapy treatment including Transcutaneous Electrical Nerve Stimulation (TENS), cryotherapy (if swelling), splinting recommendations, passive or active Range of Motion (ROM), strengthening, proprioceptive, dynamic and functional training exercises. Sessions will last 45 minutes, 3 times per week for 8 weeks. Group B (Experimental): Participants will receive the same routine physical therapy protocol, plus Kinesio taping (Y-strip method) applied to the wrist joint. Each session will last 45 minutes, 3 times per week for 8 weeks. Outcome Variables: 1. Pain will be measured with the Numeric Pain Rating Scale (NPRS). 2. Wrist Functionality with the Patient-Rated Wrist Evaluation (PRWE) 3. Wrist range of motion with a universal Goniometer. Assessments will be done at baseline and after 8 weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
38
The routine physical therapy protocol includes: Transcutaneous Electrical Nerve Stimulation (TENS): 10 minutes (80 Hz, pulse width 50-100 µs); avoided if swelling is present. Cryotherapy: Used when swelling is present. Splinting: Static splints recommended for rest or night; dynamic splints for activity (as needed). Passive \& Active Range of Motion (ROM) Exercises: Flexion, extension, radial and ulnar deviation (3 sets of 7 repetitions). Manual Resistance Strengthening: Flexion, extension, radial and ulnar deviation (3 sets of 10 repetitions). Wrist Curls and Reverse Wrist Curls: 0.5-1 kg weight (3 sets of 7 repetitions). Proprioceptive Training: Wrist circles, tendon gliding (3 sets of 10 repetitions). Dynamic Strengthening: Resistance band flexion and extension (3 sets of 12 repetitions). Grip Strengthening: Soft ball/Thera putty (3 sets of 10 reps) Functional Training: Task-specific activities for 5 minutes. Frequency: 3 sessions per week for 8 weeks. Session Duration: 45 minutes
Kinesio taping will be applied in "Y" configuration using 5-cm elastic therapeutic tape. Procedure: 1. Tape Preparation: One base strip 10 cm Two tails 7-10 cm each 2. Application: Base Anchor: Placed over the carpal region above the wrist crease. Radial Tail: Applied along forearm/wrist flexors toward the thumb side. Ulnar Tail: Applied along extensor surface toward the little-finger side. 3. Aftercare: Patient checks wrist movement for comfort. Tape should remain dry for one hour post-application. Session details (combined): 45-minute sessions Heat pack or TENS for 10 minutes (if no swelling) ROM, strengthening, proprioception, dynamic training Tape applied in final 10 minutes Frequency: 3 sessions/week for 8 weeks A complete home-exercise program is also provided.
University of Lahore Teaching Hospital
Lahore, Punjab Province, Pakistan
Numeric Pain Rating Scale (NPRS)
The Numeric Pain Rating Scale (NPRS) is an 11 point scale used to assess wrist pain intensity, ranging from 0 to 10, where 0 indicates no pain and 10 indicates worst imaginable pain. Higher scores indicate greater pain intensity.
Time frame: Baseline and at the end of 8 weeks
Patient Rated Wrist Evaluation (PRWE)
The Patient Rated Wrist Evaluation (PRWE) questionnaire is a self reported questionnaire used to assess wrist pain and functional disability. The total score ranges from 0 to 100, with higher scores indicating greater pain and disability.
Time frame: Baseline and at the end of 8 weeks
Wrist Range of Motion
Wrist range of motion will be measured using a universal goniometer in degrees for wrist flexion, extension, radial deviation, and ulnar deviation. Higher values indicate greater wrist mobility.
Time frame: Baseline and at the end of 8 weeks
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