Klinik Araştırma
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Kronik Lateral Epikondilitli Bireylerde Motor Öğrenme Egzersiz Sisteminin (ZEHand) Kullanılabilirliği: Fizibilite Çalışması

Yıl 2025, Cilt: 6 Sayı: 2, 319 - 326, 26.08.2025
https://doi.org/10.59244/ktokusbd.1766823

Öz

Amaç: ZEHand, eldiven tabanlı sensör sistemi ile kavrama kuvveti, el bileği hareket hızı ve eklem sapmalarını ölçerek, verileri gerçek zamanlı olarak kullanıcıya ve klinisyene ileten bir teknoloji destekli rehabilitasyon aracıdır. Bu çalışmanın amacı, kronik lateral epikondilitli bireylerde motor öğrenme egzersizleri için geliştirilen ZEHand sisteminin fizibilitesini ve kullanılabilirlik düzeyini belirlemektir. Gereç ve Yöntem: Çalışmaya, uzman hekim tarafından kronik lateral epikondilit tanısı konmuş, 19–41 yaş aralığında 13 kadın ve 7 erkek olmak üzere toplam 20 katılımcı dahil edildi. Katılımcıların demografik verileri, istirahat ve aktivite sırasında ağrı düzeyleri (VAS), kavrama kuvveti (hidrolik el dinamometresi) ve fonksiyonel durumları (PRTEE) değerlendirildi. ZEHand sistemiyle 10 dakikalık pilot motor öğrenme eğitimi sonrasında, sistemin kullanılabilirliği Sistem Kullanılabilirlik Ölçeği (SKÖ) ile ölçüldü. Bulgular: Katılımcıların yaş ortalaması 30,35±6,79 yıl, VKİ ortalaması 21,42±2,49 kg/m² idi. İstirahat ağrısı 5,16±1,01, aktivite ağrısı 5,93±1,78, kavrama kuvveti 15,92±10,65 kg olarak bulundu. PRTEE toplam puanı 45,25±31,04 idi. SKÖ ortalama puanı 88,25±3,64 olup, 85 üzeri skor “en yüksek kullanılabilirlik” kategorisinde yer almaktadır. Sonuç: ZEHand sistemi, kronik lateral epikondilitli bireylerde yüksek düzeyde kullanılabilir bulunmuştur. Basit arayüzü, yalnızca el bileği hareketlerine odaklanması ve anlık geri bildirim sağlaması bu sonucu desteklemektedir. Bulgular, ZEHand’in geleneksel rehabilitasyona ek olarak motor öğrenme temelli teknolojik müdahalelerde etkili bir araç olabileceğini göstermektedir.

Kaynakça

  • Altan, L., Ercan, İ., & Konur, S. (2010). Reliability and validity of Turkish version of the patient rated tennis elbow evaluation. Rheumatology international, 30(8), 1049-1054. https://doi.org/10.1007/s00296-009-1101-6
  • Bagcaci, S., Unuvar, B. S., Gercek, H., Ugurlu, I., Sert, O. A., & Yilmaz, K. (2023). A randomized controlled trial on pain, grip strength, and functionality in lateral elbow pain: Mulligan vs muscle energy techniques. Journal of Back and Musculoskeletal Rehabilitation, 36(2), 419-427. https://doi.org/10.3233/bmr-220061
  • Bhabra, G., Wang, A., Ebert, J. R., Edwards, P., Zheng, M., & Zheng, M. H. (2016). Lateral elbow tendinopathy: development of a pathophysiology-based treatment algorithm. Orthopaedic journal of sports medicine, 4(11), 2325967116670635. https://doi.org/10.1177/2325967116670635 Burns, E., Chipchase, L. S., & Schabrun, S. M. (2016). Altered function of intracortical networks in chronic lateral epicondylalgia. European Journal of Pain, 20(7), 1166-1175. https://doi.org/10.1002/ejp.841
  • Chen, Y., Hu, C.-L., Hong, C.-K., Hsu, K.-L., Kuan, F.-C., Chen, W.-L., Su, W.-R., Chen, Y.-C., & Hwang, I.-S. (2023). Deficits in neuromuscular control of increasing force in patients with chronic lateral epicondylitis. Frontiers in Physiology, 14, 1178557. https://doi.org/10.3389/fphys.2023.1178557
  • Coombes, B. K., Bisset, L., Brooks, P., Khan, A., & Vicenzino, B. (2013). Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. Jama, 309(5), 461-469. https://doi.org/10.1001/jama.2013.129
  • Demirkol, D., & Şeneler, Ç. (2018). A Turkish translation of the system usability scale: The SUS-TR. Uşak Üniversitesi Sosyal Bilimler Dergisi, 11(3), 237-253. http://dx.doi.org/10.29217/uujss.495
  • Graber, J., Hinrichs‐Kinney, L. A., Churchill, L., Matlock, D. D., Kittelson, A., Lutz, A., Bade, M., & Stevens‐Lapsley, J. (2025). Implementation of a “People‐Like‐Me” Tool for Personalized Rehabilitation After Total Knee Arthroplasty: A Mixed Methods Pilot Study. Journal of Evaluation in Clinical Practice, 31(1), e70028. https://doi.org/10.1111/jep.70028
  • Jervis-Rademeyer, H., Gautam, S., Cornell, S., Khan, J., Wilanowski, D., Musselman, K. E., Noonan, V. K., Wolfe, D. L., Baldini, R., & Kennedy, S. (2025). Development of a functional electrical stimulation cycling toolkit for spinal cord injury rehabilitation in acute care hospitals: A participatory action approach. PLoS One, 20(2), e0316296. https://doi.org/10.1016/j.apmr.2024.02.360
  • Kantan, P. R., Dahl, S., Jørgensen, H. R., & Spaich, E. G. (2024). Making Movement Sonification Usable in Clinical Gait Rehabilitation: A User-Centered Study. Proceedings of the 19th International Audio Mostly Conference: Explorations in Sonic Cultures, https://doi.org/10.1145/3678299.3678304
  • Krakauer, J. W., Hadjiosif, A. M., Xu, J., Wong, A. L., & Haith, A. M. (2019). Motor learning. Comprehensive physiology, 9(2), 613-663. https://doi.org/10.1002/j.2040-4603.2019.tb00069.x
  • Lăcraru, A.-E., Busnatu, Ș.-S., Pană, M.-A., Olteanu, G., Șerbănoiu, L., Gand, K., Schlieter, H., Kyriazakos, S., Ceban, O., & Andrei, C. L. (2023). Assessing the efficacy of a virtual assistant in the remote cardiac rehabilitation of heart failure and ischemic heart disease patients: case-control study of Romanian adult patients. International Journal of Environmental Research and Public Health, 20(5), 3937. https://doi.org/10.3390/ijerph20053937 Leech, K. A., Roemmich, R. T., Gordon, J., Reisman, D. S., & Cherry-Allen, K. M. (2022). Updates in motor learning: implications for physical therapist practice and education. Physical therapy, 102(1), pzab250. https://doi.org/10.1093/ptj/pzab250
  • Lewis, J. R. (2018). The system usability scale: past, present, and future. International Journal of Human–Computer Interaction, 34(7), 577-590. https://doi.org/10.1561/9781601983770
  • Lewis, J. R., & Sauro, J. (2018). Item benchmarks for the system usability scale. Journal of Usability studies, 13(3). https://uxpajournal.org/wp-content/uploads/sites/7/pdf/JUS_Lewis_May2018.pdf
  • Overend, T. J., Wuori-Fearn, J. L., Kramer, J. F., & MacDermid, J. C. (1999). Reliability of a patient-rated forearm evaluation questionnaire for patients with lateral epicondylitis. Journal of Hand Therapy, 12(1), 31-37. https://doi.org/10.1016/s0894-1130(99)80031-3
  • Ríos-Hernández, M., Jacinto-Villegas, J. M., Portillo-Rodríguez, O., & Vilchis-González, A. H. (2021). User-centered design and evaluation of an upper limb rehabilitation system with a virtual environment. Applied Sciences, 11(20), 9500. https://doi.org/10.3390/app11209500
  • Sanders Jr, T. L., Maradit Kremers, H., Bryan, A. J., Ransom, J. E., Smith, J., & Morrey, B. F. (2015). The epidemiology and health care burden of tennis elbow: a population-based study. The American journal of sports medicine, 43(5), 1066-1071. https://doi.org/10.1177/0363546514568087
  • Sandhu, K., Kahal, K., Singh, J., Singh, J., & Grewal, H. (2020). A comparative study of activated platelet rich plasma versus local corticosteroid injection for the treatment of lateral epicondylitis: A randomised study. Int J Orthop, 6(1), 1274-1276. https://doi.org/10.18535/jmscr/v6i10.88
  • Schabrun, S. M., Hodges, P. W., Vicenzino, B., Jones, E., & Chipchase, L. S. (2014). Novel adaptations in motor cortical maps: the relationship to persistent elbow pain. Med Sci Sports Exerc, 5(1), 1-34. https://doi.org/10.3389/conf.fnhum.2015.217.00141
  • Wiebusch, M., Coombes, B. K., & Silva, M. F. (2021). Joint position sense, motor imagery and tactile acuity in lateral elbow tendinopathy: a cross-sectional study. Musculoskeletal Science and Practice, 55, 102422. https://doi.org/10.1016/j.msksp.2021.102422

The Usability of the Motor Learning Exercise System (ZEHand) in Individuals with Chronic Lateral Epicondylitis: A Feasibility Study

Yıl 2025, Cilt: 6 Sayı: 2, 319 - 326, 26.08.2025
https://doi.org/10.59244/ktokusbd.1766823

Öz

Objective: ZEHand is a technology-assisted rehabilitation tool that measures grip strength, wrist movement speed, and joint deviations using a glove-based sensor system and transmits the data in real time to the user and clinician. The aim of this study is to determine the feasibility and usability of the ZEHand system developed for motor learning exercises in individuals with chronic lateral epicondylitis. Material and Methods: The study included a total of 20 participants, 13 women and 7 men aged 19–41, who had been diagnosed with chronic lateral epicondylitis by a specialist physician. Participants' demographic data, pain levels during rest and activity (VAS), grip strength (hydraulic hand dynamometer), and functional status (PRTEE) were evaluated. After a 10-minute pilot motor learning training session with the ZEHand system, the system's usability was measured using the System Usability Scale (SUS). Results: The average age of participants was 30.35±6.79 years, and the average BMI was 21.42±2.49 kg/m². Resting pain was 5.16±1.01, activity pain was 5.93±1.78, and grip strength was 15.92±10.65 kg. The total PRTEE score was 45.25 ± 31.04. The average SKÖ score was 88.25 ± 3.64, with scores above 85 falling into the "highest usability" category. Conclusion: The ZEHand system has been found to be highly usable in individuals with chronic lateral epicondylitis. Its simple interface, focus on wrist movements only, and provision of instant feedback support this result. The findings suggest that ZEHand may be an effective tool in motor learning-based technological interventions in addition to traditional rehabilitation.

Kaynakça

  • Altan, L., Ercan, İ., & Konur, S. (2010). Reliability and validity of Turkish version of the patient rated tennis elbow evaluation. Rheumatology international, 30(8), 1049-1054. https://doi.org/10.1007/s00296-009-1101-6
  • Bagcaci, S., Unuvar, B. S., Gercek, H., Ugurlu, I., Sert, O. A., & Yilmaz, K. (2023). A randomized controlled trial on pain, grip strength, and functionality in lateral elbow pain: Mulligan vs muscle energy techniques. Journal of Back and Musculoskeletal Rehabilitation, 36(2), 419-427. https://doi.org/10.3233/bmr-220061
  • Bhabra, G., Wang, A., Ebert, J. R., Edwards, P., Zheng, M., & Zheng, M. H. (2016). Lateral elbow tendinopathy: development of a pathophysiology-based treatment algorithm. Orthopaedic journal of sports medicine, 4(11), 2325967116670635. https://doi.org/10.1177/2325967116670635 Burns, E., Chipchase, L. S., & Schabrun, S. M. (2016). Altered function of intracortical networks in chronic lateral epicondylalgia. European Journal of Pain, 20(7), 1166-1175. https://doi.org/10.1002/ejp.841
  • Chen, Y., Hu, C.-L., Hong, C.-K., Hsu, K.-L., Kuan, F.-C., Chen, W.-L., Su, W.-R., Chen, Y.-C., & Hwang, I.-S. (2023). Deficits in neuromuscular control of increasing force in patients with chronic lateral epicondylitis. Frontiers in Physiology, 14, 1178557. https://doi.org/10.3389/fphys.2023.1178557
  • Coombes, B. K., Bisset, L., Brooks, P., Khan, A., & Vicenzino, B. (2013). Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. Jama, 309(5), 461-469. https://doi.org/10.1001/jama.2013.129
  • Demirkol, D., & Şeneler, Ç. (2018). A Turkish translation of the system usability scale: The SUS-TR. Uşak Üniversitesi Sosyal Bilimler Dergisi, 11(3), 237-253. http://dx.doi.org/10.29217/uujss.495
  • Graber, J., Hinrichs‐Kinney, L. A., Churchill, L., Matlock, D. D., Kittelson, A., Lutz, A., Bade, M., & Stevens‐Lapsley, J. (2025). Implementation of a “People‐Like‐Me” Tool for Personalized Rehabilitation After Total Knee Arthroplasty: A Mixed Methods Pilot Study. Journal of Evaluation in Clinical Practice, 31(1), e70028. https://doi.org/10.1111/jep.70028
  • Jervis-Rademeyer, H., Gautam, S., Cornell, S., Khan, J., Wilanowski, D., Musselman, K. E., Noonan, V. K., Wolfe, D. L., Baldini, R., & Kennedy, S. (2025). Development of a functional electrical stimulation cycling toolkit for spinal cord injury rehabilitation in acute care hospitals: A participatory action approach. PLoS One, 20(2), e0316296. https://doi.org/10.1016/j.apmr.2024.02.360
  • Kantan, P. R., Dahl, S., Jørgensen, H. R., & Spaich, E. G. (2024). Making Movement Sonification Usable in Clinical Gait Rehabilitation: A User-Centered Study. Proceedings of the 19th International Audio Mostly Conference: Explorations in Sonic Cultures, https://doi.org/10.1145/3678299.3678304
  • Krakauer, J. W., Hadjiosif, A. M., Xu, J., Wong, A. L., & Haith, A. M. (2019). Motor learning. Comprehensive physiology, 9(2), 613-663. https://doi.org/10.1002/j.2040-4603.2019.tb00069.x
  • Lăcraru, A.-E., Busnatu, Ș.-S., Pană, M.-A., Olteanu, G., Șerbănoiu, L., Gand, K., Schlieter, H., Kyriazakos, S., Ceban, O., & Andrei, C. L. (2023). Assessing the efficacy of a virtual assistant in the remote cardiac rehabilitation of heart failure and ischemic heart disease patients: case-control study of Romanian adult patients. International Journal of Environmental Research and Public Health, 20(5), 3937. https://doi.org/10.3390/ijerph20053937 Leech, K. A., Roemmich, R. T., Gordon, J., Reisman, D. S., & Cherry-Allen, K. M. (2022). Updates in motor learning: implications for physical therapist practice and education. Physical therapy, 102(1), pzab250. https://doi.org/10.1093/ptj/pzab250
  • Lewis, J. R. (2018). The system usability scale: past, present, and future. International Journal of Human–Computer Interaction, 34(7), 577-590. https://doi.org/10.1561/9781601983770
  • Lewis, J. R., & Sauro, J. (2018). Item benchmarks for the system usability scale. Journal of Usability studies, 13(3). https://uxpajournal.org/wp-content/uploads/sites/7/pdf/JUS_Lewis_May2018.pdf
  • Overend, T. J., Wuori-Fearn, J. L., Kramer, J. F., & MacDermid, J. C. (1999). Reliability of a patient-rated forearm evaluation questionnaire for patients with lateral epicondylitis. Journal of Hand Therapy, 12(1), 31-37. https://doi.org/10.1016/s0894-1130(99)80031-3
  • Ríos-Hernández, M., Jacinto-Villegas, J. M., Portillo-Rodríguez, O., & Vilchis-González, A. H. (2021). User-centered design and evaluation of an upper limb rehabilitation system with a virtual environment. Applied Sciences, 11(20), 9500. https://doi.org/10.3390/app11209500
  • Sanders Jr, T. L., Maradit Kremers, H., Bryan, A. J., Ransom, J. E., Smith, J., & Morrey, B. F. (2015). The epidemiology and health care burden of tennis elbow: a population-based study. The American journal of sports medicine, 43(5), 1066-1071. https://doi.org/10.1177/0363546514568087
  • Sandhu, K., Kahal, K., Singh, J., Singh, J., & Grewal, H. (2020). A comparative study of activated platelet rich plasma versus local corticosteroid injection for the treatment of lateral epicondylitis: A randomised study. Int J Orthop, 6(1), 1274-1276. https://doi.org/10.18535/jmscr/v6i10.88
  • Schabrun, S. M., Hodges, P. W., Vicenzino, B., Jones, E., & Chipchase, L. S. (2014). Novel adaptations in motor cortical maps: the relationship to persistent elbow pain. Med Sci Sports Exerc, 5(1), 1-34. https://doi.org/10.3389/conf.fnhum.2015.217.00141
  • Wiebusch, M., Coombes, B. K., & Silva, M. F. (2021). Joint position sense, motor imagery and tactile acuity in lateral elbow tendinopathy: a cross-sectional study. Musculoskeletal Science and Practice, 55, 102422. https://doi.org/10.1016/j.msksp.2021.102422
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Fizyoterapi
Bölüm Klinik Araştırma
Yazarlar

Hasan Gerçek 0000-0001-7459-4452

Zubeyir Sarı 0000-0003-1643-5415

Erken Görünüm Tarihi 24 Ağustos 2025
Yayımlanma Tarihi 26 Ağustos 2025
Gönderilme Tarihi 16 Ağustos 2025
Kabul Tarihi 22 Ağustos 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 6 Sayı: 2

Kaynak Göster

APA Gerçek, H., & Sarı, Z. (2025). The Usability of the Motor Learning Exercise System (ZEHand) in Individuals with Chronic Lateral Epicondylitis: A Feasibility Study. KTO Karatay Üniversitesi Sağlık Bilimleri Dergisi, 6(2), 319-326. https://doi.org/10.59244/ktokusbd.1766823