Overview

Hand injuries and diseases are common reasons for hospital visits and lead to both functional and workforce losses, making them a persistent problem in treatment and rehabilitation approaches. Among the various functions of the hand, the thumb is of particular importance due to its large representation in the brain and its contribution to all gripping and holding functions. Loss of function in the thumb leads to a loss of at least 40% of hand skills. Therefore, restoring the thumb's original functionality is this study primary goal in rehabilitation. To achieve this goal, intensive rehabilitation is required, which cannot be fully accomplished through clinic sessions alone, as home exercises contribute significantly to this process. The low adherence of patients to home exercises has led researchers to explore various alternatives.

The aim of this study is to investigate the effect of mobile application games on rehabilitation outcomes in patients who have lost thumb function. For the pre- and post-treatment evaluations of the patients, the following assessment tools will be used: the Visual Analog Scale (VAS) for pain, the eight-shaped tape measure for edema, the Quick-DASH (Disabilities of the Arm, Shoulder, and Hand) scale for upper extremity functionality, a finger goniometer for joint range of motion, the DuruÖz Hand Index for measuring activities of daily living, and a home exercise adherence tracking form to evaluate adherence to home exercises.

As determined by this study power analysis, 38 patients with thumb injuries will be included in the study. These patients will be randomly assigned into two groups: the routine treatment group (19 patients) and the routine treatment plus mobile game group (19 patients). The routine treatment group will receive standard treatment at the Kırşehir Ahi Evran University Faculty of Physiotherapy and Rehabilitation Hand Clinic, including classical massage, stretching, functional exercises, electrical modalities, thermal agents, and home exercises. In the routine treatment plus mobile game group, in addition to the standard treatment, patients will engage in 20-30 minutes of mobile application games (e.g., Temple Run, Flappy Bird, Angry Birds) as part of their home exercise program.

Researchers hypothesize that the group receiving mobile games in addition to the standard treatment will experience a better rehabilitation process in terms of thumb functionality, pain, and edema compared to the routine treatment group, and they will reach rehabilitation goals more quickly. Additionally, mobile games will increase motivation for home exercises and improve adherence. This study will be the first to examine the use of mobile games in thumb rehabilitation and their effect on adherence to home exercises. Researchers anticipate that the results of this study will inspire both clinicians and future research, reaching a wider audience through presentations and publications.

Eligibility

Inclusion Criteria:

• Patients aged 18-65
• With sufficient communication skills
• Experiencing pain and functional impairment in the thumb (e.g., thumb fractures, tendon injuries, nerve injuries, osteoarthritis, trigger thumb, carpal tunnel syndrome, ligament injuries, soft tissue damage, etc.),
• who are willing to volunteer.

Exclusion Criteria:

• Illiteracy, lack of a smartphone, or the presence of neurological, orthopedic, or rheumatological chronic diseases in the affected limb.