The aim of this study was to investigate the effects of game-based electromyography (EMG)-biofeedback therapy on swallowing functions and quality of life in patients with post-stroke dysphagia. This prospective, assessor-blind, randomized controlled trial included 33 patients with post-stroke dysphagia. The study group performed the Mendelsohn maneuver and effortful swallow using game-based EMG-biofeedback, while the control group performed the same tasks with only verbal feedback for 30 min across a total of 15 sessions. In addition, both groups received oral motor exercises and thermal-tactile stimulation for equal durations. Patients were evaluated immediately before and after the treatment using clinical swallowing assessments, including the Functional Oral Intake Scale (FOIS), Penetration-Aspiration Scale (PAS), Dysphagia Outcome and Severity Scale (DOSS), and Dysphagia Handicap Index (DHI). Statistically significant improvements were observed in FOIS scores (p = 0.038), PAS-Liquid scores (p = 0.026), and DOSS scores (p = 0.003) in the study group, while no significant changes were noted in the control group. PAS-Semisolid scores improved in both groups (study group, p = 0.002; control group, p = 0.023); however, post-treatment scores were significantly higher in the study group compared to the control group (p = 0.031). Although significant improvements in DHI total, physical, emotional, and functional scores were observed in both groups at the end of treatment (all p < 0.05), post-treatment DHI scores were significantly higher in the study group compared to the control group (all p < 0.05). The addition of game-based EMG-biofeedback to conventional therapy improved clinical and radiological outcomes, as evidenced by improvements in FOIS, PAS-Liquid, and DOSS scores, and led to statistically significant improvements in PAS-Semisolid and DHI scores. In conclusion, the inclusion of game-based EMG-biofeedback therapy in swallowing rehabilitation programs may have a positive impact on treatment outcomes.

Introduction: In patients with neurological disorders Whole Body Vibration (WBV) has been reported to improve motor function. Our aim was to assess the effects of WBV on both balance and walking performance in adult stroke patients. Methods: Forty three post-stroke patients were randomly divided into two groups. One would receive WBV therapy (WBV group) while the control group would not. All patients participated in a conventional rehabilitation program for three weeks while the vibration group also received WBV over the same period. Patients balance and walking performance were evaluated using the Berg Balance Scale (BBS), Timed Up and Go Test (TUG) and computerized gait analysis. All evaluations were performed before and after therapy. Results: The median (range) age of all patients was 51.00 (18-66) years. The groups numbered 26 and 17 patients for the WBV and control groups respectively. After intervention, significant improvements were found in the WBV group for BBS score (p=0.004), TUG score (p=0.035), step length (p=0.004) and walking speed (p=0.031) when compared to the controls. Conclusion: WBV is effective for the improvement of balance and gait performance in stroke patients.

[Purpose] The primary aim of this study was to assess rehabilitation outcomes for early and two-stage repair of hand flexor tendon injuries. The secondary purpose of this study was to compare the findings between treatment groups. [Subjects and Methods] Twenty-three patients were included in this study. Early repair (n=14) and two-stage repair (n=9) groups were included in a rehabilitation program that used hand splints. This retrospective evaluated patients according to their demographic characteristics, including age, gender, injured hand, dominant hand, cause of injury, zone of injury, number of affected fingers, and accompanying injuries. Pain, range of motion, and grip strength were evaluated using a visual analog scale, goniometer, and dynamometer, respectively. [Results] Both groups showed significant improvements in pain and finger flexion after treatment compared with baseline measurements. However, no significant differences were observed between the two treatment groups. Similar results were obtained for grip strength and pinch grip, whereas gross grip was better in the early tendon repair group. [Conclusion] Early and two-stage reconstruction of patients with flexor tendon injuries can be performed with similarly favorable responses and effective rehabilitation programs.

Objectives: The purpose of this study was to investigate the effectiveness of mirror therapy on pain, sensory, and functional development in addition to conventional rehabilitation and occupational practices in patients with a peripheral nerve injury in the hand. Patients and methods: Twenty-six patients with peripheral nerve injury in the hand were included in this randomized controlled study between November 2017 and May 2018. The patients were randomly assigned to the mirror group (n=14) and the control (n=12) group. Both groups received conventional therapy in our clinic for 45 min a day during weekdays for six consecutive weeks. The mirror group received an additional 10-15 min of visual mirror therapy. Visual Analog Scale (VAS), Duruöz Hand Index, Quick Disabilities of the Arm, Shoulder, and Hand, Jebsen hand function test, and Semmes-Weinstein monofilament test were used for the assessment of pain, hand function, and sensation of the patients at baseline and after treatment. The handgrip strength of the patients was measured with a dynamometer. Results: A total of 20 patients (17 males, 3 females; mean age 31.9±16.5, range 16 to 65 years) completed the study, with 10 in each group. Statistically significant improvement was detected in hand skill functions, such as page-turning (p=0.004), backgammon packing (p=0.023), and heavy object lifting (p=0.029) in the mirror group. A statistically significant decrease was found in total scores of VAS after treatment in both groups (p<0.05). Conclusion: The results imply that mirror therapy integrated with conventional rehabilitation may aid additional benefits on hand functions in peripheral nerve injury. These results demonstrate that mirror therapy can be used in addition to the rehabilitation program of patients with peripheral nerve injury.

Objective: This study aimed to investigate the relationship between post-traumatic pain levels in patients with hand-wrist injuries and symptoms of depression, activity participation, and quality of life. Methods: The study included 44 patients who presented to the Physical Therapy and Traumatic Hand Injury Outpatient Clinic withvarious diagnoses of traumatic hand injuries. Eligible patients had sustained traumatic hand injuries up to 10 cm proximal to the wrist, had no prior diagnosis of depression, and presented to the clinic for the first time between postoperative days 3 and 10. Pain severity was assessed using the Visual Analog Scale (VAS), activity participation was evaluated with the Quick Disability of the Arm, Shoulder, and Hand Questionnaire (Q-DASH), health-related quality of life was measured with the European Quality of Life Five Dimension Five Level Scale (EQ-5D-3L), and depression symptoms were assessed using the Beck’s Depression Inventory (BDI). Results: All patients included in the study had at least one injured structure. The majority of the patients were male and worked inblue-collar occupations. The depressive symptoms were classified as moderately severe (BDI score ≥ 17). Among the injured structures, tendon injuries were the most common, and post-traumatic injuries were the most frequently observed type. Visual Analog Scale scores were significantly higher in tendon-fracture and tendon-nerve injuries compared to tendon injuries alone (P=.038 and P < .001, respectively). Quick Disability of the Arm, Shoulder, and Hand Questionnaire scores were significantly higher in tendon-nerve injuries than in tendon injuries (P < .001). Beck’s Depression Inventory scores were significantly higher in tendon-nerve injuries than in bone and tendon injuries (P=.006 and P < .001, respectively). European Quality of Life Five Dimension Five Level Scale index scores were significantly lower in tendon-nerve injuries compared to bone and tendon injuries (P=.002 and P < .001, respectively). Correlation analysis revealed that VAS, QuickDASH, and BDI scores were not correlated with age. However, there was a strong positive correlation between VAS and QuickDASH scores, VAS and BDI scores, and QuickDASH and BDI scores. Conclusion: The findings suggest that pain management and psychological support interventions should be integrated into the rehabilitation process for patients with traumatic hand injuries. Addressing both pain and depressive symptoms during recovery may help minimize their negative impact on quality of life and improve activity participation. Cite this article as: Kablanoğlu S, Sade SI. The relationship between pain and activity participation, quality of life and depression symptoms in traumatic hand injuries. Acta Orthop Traumatol Turc., 2025;59(3):146-151.

Introduction: in patients with neurological disorders Whole Body Vibration (WBV) has been reported to improve motor function. Our aim was to assess the effects of WBV on upper extremity function in adult stroke patients. Methods: Forty-three post-stroke patients were randomly assigned to two groups: treatment group and control group. The demographic characteristics and Modified Ashworth Scale (MAS) were recorded in all patients. The plegic upper extremity range of motions (ROM) and motor functions were evaluated by goniometric measurement and Jebsen-Taylor Hand Function Test (JTHFT). All patients participated in a conventional rehabilitation program for three weeks while the treatment group also received WBV over the same period. All evaluations were performed before and after therapy. Results: The median (range) age of all patients was 51.0 +/- 13.7 (18-66) years. The groups numbered 26 and 17 patients for the treatment and control groups respectively. No significant differences were found between the two groups in the pre-treatment evaluation based on the JTHFT all scores (p>0.05). Significant improvement was found in the elbow extension ROM degree (p=0.019) for the treatment group. A statistically significant improvement was observed in all parameters of JTHFT in the treatment group after the intervention, whereas only page turning, removing small objects, removing large light objects and removing large heavy objects showed a statistically significant improvement in controls (p<0.05). Conclusion: Statistically significant differences were observed between the treatment and control groups after intervention. WBV treatment is effective for the improvement of ROM and upper extremity functions in stroke patients.