Overuse syndrome or RSI is challenging condition among clinicians now a days. These are MSK disorders which are related to bones, muscles and tendons peripheral nerve entrapment and vascular changes. These MSK disorders commonly effects back, neck and upper limbs although it least effect lower limbs. These problems occur from repetitive movements, ergonomic hazards, awkward postures and work related problems. This study aims to assess the comparative effects of 3 dimensional articular myofascial release approach and soft tissue myofascial release approach in patients with overuse syndrome of wrist joint. A randomized controlled trial will be conducted age between 20-55 years, both male and female genders will be included diagnosed with overuse syndrome of wrist. Diagnosis will be made on the basis of diagnostic criteria which will include tenderness present in intrinsic muscles and pain in radial ligament of wrist. Participants will be chosen through consecutive sampling. Each participant will sign a consent form before taking part in the study. According to sample size 46 participants will be divided into two groups. Each group will include 23 participants which will be divided through lottery method. Both groups will receive baseline treatment which will include hot-pack for 15 minutes. Group a will be treated with articular fascial release and group b will be treated with soft tissue release for 3 sessions per week, for 3 weeks. After therapy session both groups will perform wrist rom exercises including wrist flexion, extension, radial and ulnar deviation 5 repetitions each. Outcome measuring tools will be numeric pain rating scale (NPRS) for pain, disabilities of arm, shoulder and hand (DASH) for functional disability, patient rated wrist evaluation (PRWE) specifically wrist functions evaluation and goniometer for range of motion. Data will be investigated through SPSS.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
46
Hot pack for 15 mins.3- dimensional Articular fascial release approach
Hot pack for 15 mins. 3 Dimensional soft tissue release approach * Technique: Apply gentle sustained pressure in all three planes. Hold 30-90 seconds while sensing tissue give hold until all the symptoms and fascial release feel. Encourage slow diaphragmatic breathing exhalation facilitates release. 4. Avoid: Pressure on bony surfaces and nerve trunks area 5. Dose and frequency * Per site 8-12 minutes of fulcrum work (including holds and plane cycles) * Session: 20-40 minutes total including warm up, 1-3 fulcrum site integration and education 6\. Frequency: Total 3 weeks, per week 3 sessions, total sessions 7. After treatment will include ROM exercises including wrist flexion, extension, radial deviation and ulnar devi
Dr Rubina Zulfqar
Faisalabad, Punjab Province, Pakistan
RECRUITINGPain Intensity
Pain Intensity will be measured by using the Numeric Pain Rating Scale, the patients rate their pain on a scale from 0 (no pain) to 10 (worst possible pain).NPRS scale consists of 11 points in which 0 is no pain while 10 is worst pain.
Time frame: 3 weeks
Range of Motion
Range of Motion will be measured by using Goniometry the improvement in ROM shows good results.
Time frame: 3 weeks
Functional disability
Functional disability will be measured by using The Disabilities of Arm, Shoulder and Hand (DASH) and Patient-rated wrist evaluation form (PRWE). The DASH questionnaire is consists of thirty items which asses the physical function and symptoms. It involve five options for response of each item. Ultimate score is calculated through the formula below: DASH score = {(sum of n responses)-1}\*25, n=number of complete responses, the highest score showed improvement. While The PRWE is a self administrated questionnaire which is patient specific which consist of 15 items. It was designed for measurement of activities of daily living of wrist pain and disability and consist of 2 subscales; pain and function.A score of 100 represent the worst functional score while the score 0 indicate no disability.
Time frame: 3 weeks
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