The effect of proprioceptive neuromuscular facilitation (PNF) – based stretching and mulligan mobilization on kinesiophobia and proprioception in wrist joint limitation after distal radius fractures

The aim of the study was to determine the effect of PNF based stretching and Mulligan mobilization, applied in addition to traditional treatment, on pain, proprioception (joint position sense), wrist functionality, muscle strength and kinesiophobia in patients with joint limitation after distal radius end fracture. In the study, algometer and Visual Analog Scale (VAS) were used to evaluate the pain intensity of the patients, universal goniometer was used to evaluate joint range of motion, and microFET®2 Digital Handheld Dynamometer device was used to evaluate muscle strength. A patient-based wrist evaluation questionnaire was used to evaluate the functionality of the individuals, joint position sense for proprioception, and the Tampa Kinesiophobia Scale (TKS) for kinesiophobia. A total of 34 cases were subjected to an exercise program of 45 minutes, 2 days a week for 6 weeks. To the first group (n=17); Mulligan mobilization was applied in addition to traditional treatment, and the 'hold-relax' technique, one of the PNF techniques, was applied to the second group (n = 17) in addition to traditional treatment. While the pre-treatment vas rest measurements of the groups were statistically different from each other (p<0.05); pre-treatment, vas night and vas movement values were similar. Pain threshold values measured by algometer increased statistically significantly in both groups (p<0.05). ROM and muscle strength values increased statistically significantly in both groups when compared pre and post treatment (p<0.05). In proprioception evaluation, deviation angles decreased statistically significantly only in Group 2 when compared pre and post treatment (p<0.05). When the TKS values and PRWHE parameters of the groups were compared pre and post treatment, there was a statistically significant decrease in both groups (p<0.05). Both techniques applied in this study were found to have positive effects on pain, kinesiophobia and proprioception.