Early effects of graded motor imagery training in patients with hand flexor tendon repair

Objective: The aim of our study is to examine the early effects of graded motor imagery training on pain, functionality, kinesiophobia and joint movement in patients who underwent flexor tendon repair. Method: 26 individuals (29 fingers) who underwent zone I-III flexor tendon repair participated in this study. Randomization was provided into Group I (early passive movement-EPH) and Group II (graded motor imagery training-GMI). Early passive movement protocol was applied in Group I, and graded motor imagery training combined with early passive movement protocol was applied in Group II. Rehabilitation in both groups was 60-70 minutes a day, 5 days a week totally 6 weeks. Pain was evaluated with the Visual Analog Scale, joint movements were evaluated with a goniometer, functional level was evaluated with the Arm Shoulder and Hand Disorders Questionnaire Short Form, and kinesiophobia was evaluated with the Tampa Kinesiophobia Scale (TKÖ). Evaluations were taken before rehabilitation (0-3 weeks postoperatively, average 16,72. day), at the 6th week postoperatively and at the 8th week postoperatively. Results: Sociodemographic and clinical characteristics of the groups were similar, except for rest pain (p>0.05). A significant improvement was detected in the pain, functionality and kinesiophobia scores in the GMI group, and in the functionality scores in the EPH group, before and after rehabilitation, and in the intra-group comparison between pre-rehabilitation and postoperative 6th week, and postoperative 6th week and 8th week (p<0.05). A significant improvement was found in all scores before and after rehabilitation in both groups (p<0.05). While a significant difference was found between the groups in favor of Group II in the VAS resting score at the 6th postoperative week, VAS activity score at the 6th week and the 8th week (p<0.05), no significant difference was found between the groups in the Q-DASH and TKS scores (p>0.05). Postoperative 6-8. according to the joint range of motion classification system, a significant difference was found between the groups in favor of Group II between weeks (p<0.05). Conclusion: In patients who underwent flexor tendon repair, improvements in pain, functionality, kinesiophobia and joint range of motion were achieved with EPH and GMI applied in combination to EPH, and the improvements achieved were similar in both groups. At the end of the GMI program combined with the EPH program, it was found that activity pain decreased more and the classification results of active joint movement were superior to the group that only EPH. Keywords: Flexor tendon repair, Early movement, Graded motor imagery, Function, Kinesiophobia