Introduction
Physical problems in women after childbirth are considered a risk factor for health and emotional well-being, and various musculoskeletal pains such as back, neck, and shoulders are common.
Wrist pain that occurs after childbirth is called “DeQuervain Disease” or “baby wrist” and is common in clinical practice. This pain is due to several causes including strain and joint relaxation.
In a study in which taping was applied to patients with injured wrist and lower back joints, it was reported that there was an effect of improving pain and muscle strength. Park Jin-Hyun and Kim Gyeong reported that the grip strength and muscle activity were improved as a result of taping in patients with lateral gastric arthritis. It is said that taping can improve the motor function of the muscle by increasing blood and lymph circulation between the muscle and the skin, and prevent secondary damage by improving the function of the damaged muscle and joint.
Several studies report that taping significantly improved pain and dysfunction, but studies on wrist pain in women after childbirth are insufficient. In addition, it has not been confirmed that there is a more significant therapeutic effect when combined with stabilization exercise in a relaxed state of the joint after childbirth.

Aim
The purpose of this study is to evaluate the effects of wrist stabilization exercise combined with taping on wrist pain, disability, and quality of life in postpartum women with wrist pain. 

Subjects
Forty-five patients with wrist pain will be recruited and randomly divided into three groups: the Wrist stabilization exercise + Taping therapy (WSE+TT) group (n=15), the Wrist stabilization exercise (WSE) group (n=15), and the control group (n=15). 

Intervention
The WSE+TT and WSE groups will perform wrist stabilization exercises for 40 minutes (once a day, five times a week for eight weeks), and the control group will perform P-ROM exercise for the same amount of time. Additionally, the WSE+TT group attach taping to the wrist and forearm during the training period. 

Outcome measurements
The VAS will be used to assess pain level of the wrist. The DASH and SF-36 will be used to evaluate the degree of wrist disability and quality of life, respectively.

Treatment

The intervention method was designed through an expert meeting of 3 professional therapists with more than 5 years of experience in musculoskeletal physical therapy and 2 professors in the department of physical therapy. The WSE+TT and WSE groups performed wrist stabilization exercises for 40 minutes a day for 8 weeks, using elastic bands and dumbbells. After fixing the elastic band to the ring, an isometric contraction exercise was performed for the wrist flexor and extensor, radial, and ulnar deviation muscles in a sitting or standing position so that the elastic band was at the front, back, left, and right sides of the body. In each direction, three sets of 10 repetitions were performed as a method of maintaining for 10 seconds against resistance, and a 1-minute break between sets was provided. In addition, the dumbbell was held in the hand in a sitting position, and the arm was raised to the front, back, and sideways (shoulder flexion, extension, abduction) to the height possible while maintaining the wrist in a neutral position for 10 seconds. Each was performed 10 times. Thera-Band (TheraBand, Akron, USA) offers a different amount of resistance depending on the band color. Therefore, the Thera-Band band of appropriate strength was selected for each patient by the therapist. Dumbbells were gradually increased from 0.5 kg to 2 kg according to the patient's condition every week. The control group performed passive ROM exercise for wrist flexion, extension radial & ulnar deviation instead of stabilization exercise for the same time as other groups for the same time period.
For taping, an elastic tape of about 60-80 cm in length was used depending on the length of the forearm, and with the muscle stretched as much as possible, the wrist extensor and flexor muscles were attached from the origin to insertion site of the muscle. An elastic tape of approximately 15 cm in length was wound around the wrist one round starting from the radial side of the wrist.

Arm Label

Target Number of Participant

Arm Type

Arm Description

WSE+TT group performs wrist stabilization exercises for 40 minutes a day for 8 weeks, using elastic bands and dumbbells. After fixing the elastic band to the ring, an isometric contraction exercise is performed for the wrist flexor and extensor, radial, and ulnar deviation muscles in a sitting or standing position so that the elastic band is at the front, back, left, and right sides of the body.
In each direction, three sets of 10 repetitions are performed as a method of maintaining for 10 seconds against resistance, and a 1-minute break between sets is provided.
In addition, the dumbbell is held in the hand in a sitting position, and the arm is raised to the front, back, and sideways (shoulder flexion, extension, abduction) to the height possible while maintaining the wrist in a neutral position for 10 seconds. Each was performed 10 times.
Thera-Band (TheraBand, Akron, USA) offers a different amount of resistance depending on the band color. Therefore, the Thera-Band band of appropriate strength is selected for each patient by the therapist. Dumbbells are gradually increased from 0.5 kg to 2 kg according to the patient's condition every week.
For taping, an elastic tape of about 60-80 cm in length is used depending on the length of the forearm, and with the muscle stretched as much as possible, the wrist extensor and flexor muscles were attached from the origin to insertion site of the muscle. An elastic tape of approximately 15 cm in length is wound around the wrist one round starting from the radial side of the wrist.

Arm Label

Target Number of Participant

Arm Type

Arm Description

WSE group performs wrist stabilization exercises for 40 minutes a day for 8 weeks, using elastic bands and dumbbells. After fixing the elastic band to the ring, an isometric contraction exercise is performed for the wrist flexor and extensor, radial, and ulnar deviation muscles in a sitting or standing position so that the elastic band is at the front, back, left, and right sides of the body.
In each direction, three sets of 10 repetitions are performed as a method of maintaining for 10 seconds against resistance, and a 1-minute break between sets is provided.
In addition, the dumbbell is held in the hand in a sitting position, and the arm is raised to the front, back, and sideways (shoulder flexion, extension, abduction) to the height possible while maintaining the wrist in a neutral position for 10 seconds. Each was performed 10 times.
Thera-Band (TheraBand, Akron, USA) offers a different amount of resistance depending on the band color. Therefore, the Thera-Band band of appropriate strength is selected for each patient by the therapist. Dumbbells are gradually increased from 0.5 kg to 2 kg according to the patient's condition every week.

Arm Label

Target Number of Participant

Arm Type

Arm Description

The control group performs passive ROM exercise for wrist flexion, extension radial & ulnar deviation instead of stabilization exercise for the same time as other groups for the same time period.

Gender

Age

Description

Postpartum women with wrist pain has a visual analogue scale (VAS) of 30 mm or higher, and has never experienced wrist pain before pregnancy and had been given birth for less than 1 year.

Subjects taking pain-related medications or receiving other treatments are excluded.

Pain intensity using 100-mm VAS

Pre and post intervention

Wrist dysfunction using the DASH questionnaire

Pre and post intervention

Quality of life using the Short Form 36 (SF-36) questionnaire

Pre and post intervention