Clinical Research Directory

The Effect of Mulligan and GMI on Distal Radius Proprioception

Distal radius fractures are common in the elderly population and clinical findings after treatment include limitation of joint motion, pain, and muscle weakness. Physical therapy modalities include exercises, physical agents, and manual therapy techniques. The Mulligan Concept-specific mobilization with movement (MWM) technique improves joint movement by reducing pain and is effective in musculoskeletal disorders. Graded motor imagery activates the motor system, increases neuroplasticity, and promotes functional recovery. It has been observed that proprioception is impaired after distal radius fracture, affecting muscle tone and postural reflexes. Our study will examine proprioception measurements with an electrogonometer (K Force Sens) and universal goniometer and the effectiveness of MWM and progressive motor imagery treatments. The study is designed as a one-blind randomized study and a total of 33 patients between the ages of 25-65 who were treated with volar plate screws after distal radius fracture will be included. Patients will be randomized as 11 people and one group will be treated with Mulligan Mobilisation in addition to conventional physiotherapy and the other group will be treated with Graded motor imagery techniques in addition to conventional physiotherapy. The control group will receive only conventional physiotherapy. Clinical Follow-up Form, Proprioception, Kinesiophobia, Hand Grip strength, Muscle strength, Pain, and functional evaluations will be performed 2 times in total, just before the patient starts physical therapy after surgery and at the end of the 6-week treatment. A goniometer and electrogoniometer will be used to measure proprioception. Visual Analogue Scale (VAS) and algometer will be used to determine the pain assessment. Jamar's hand grip strength meter and Digital Handheld Dynamometer will be used for muscle strength assessment. Tampa Kinesiophobia Scale will be used to measure the level of kinesiophobia. Patient Rated Wrist/Hand Evaluation (PRWHE) will be used to evaluate the functionality of the patients. Proprioception evaluation in the upper extremity is limited in the literature, and it will be an original study to examine the relationship between the two measurements after distal radius fracture surgery; in addition, it will be the first study to examine graded motor imagery and mulligan Mobilisation in terms of treatment efficacy.

SNAG and SNME in Non-Specific Sciatic Pain

This study is designed as a crossover trial. All participants who meet the inclusion criteria and voluntarily agree to participate will be evaluated using the assessment methods detailed below. Subsequently, participants will be randomly assigned into two groups. The first group (Mulligan Concept Group - MCG) will receive the SNAG technique, while the second group (Neural Mobilization Group - NMG) will perform the Sciatic Nerve Mobilization Exercise (SNME). After the intervention, participants will be evaluated a second time. Ten days after this session, participants will be invited back. Those who were in the MCG group during the first session will be re-evaluated and then receive the SNGE intervention. Participants who were in the SNGE group during the first session will be re-evaluated and then receive the SNAG intervention. Following this second intervention, participants will be evaluated once again. Assessments will be done are Demographic Form, Visual Analogue Scale, Oswestry Disability Index, Joint Range of Motion, Five-times Sit-to-stand Test, Sit and Reach Test