A Pilot Study of a Neural Mobilization Intervention Applied to Older Adults With Chronic Musculoskeletal Pain
- Conditions
- Chronic PainChronic Musculoskeletal DiseaseChronic Musculoskeletal PainOlder Adults
- Interventions
- Other: Physical Exercise ProgramOther: Neural Mobilization
- Registration Number
- NCT06138314
- Lead Sponsor
- Aveiro University
- Brief Summary
The goal of this pilot study is to evaluate the feasibility of integrating neural mobilization techniques into a multimodal physical exercise program for older adults with chronic musculoskeletal pain. The main questions it aims to answer are:
* What is the average time to assess secondary outcomes for each participant?
* What proportion of participants adhered and/or withdrew from the study at the end of the intervention protocol?
* Are there adverse events/effects associated with the intervention protocol?
* What is the level of approval/satisfaction of the participants in relation to the assessment and intervention protocols?
* What is the impact of the intervention protocol on participants´ pain, function, physical performance, somatosensory function, and nerve excursion (secondary outcomes)?
Participants will be assessed at 3 different moments: initial assessment (T0), at the end of the intervention protocol (8 weeks) (T1) and 3 months after the end of the intervention protocol (T2). The intervention protocol will consist of a multimodal exercise program (with or without integration of neural mobilization techniques) to be carried out over a period of 8 weeks at a frequency of twice a week.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 30
- Community-dwelling older adults aged 60 years or older, with primary or secondary chronic musculoskeletal pain in any body site and able to walk independently
- Individuals with post-surgical pain as a result of surgery performed in the last 6 months;
- Patients with a self-reported diagnoses of infection diseases, dementia, tumor/cancer, neurodegenerative diseases, stroke, uncontrolled diabetes, or at high risk of developing cardiovascular events;
- Those with physical limitations that make it impossible for them to carry out the intervention protocols independently (e.g., wheelchair user);
- Patients who are receiving another physical therapy intervention to treat their pain.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Experimental group Neural Mobilization The experimental group will perform the same physical exercise program performed by participants in the control group, in addition to neural mobilization techniques twice a week for a period of 8 weeks. Control group Physical Exercise Program The control group will perform a physical exercise program twice a week for a period of 8 weeks. Experimental group Physical Exercise Program The experimental group will perform the same physical exercise program performed by participants in the control group, in addition to neural mobilization techniques twice a week for a period of 8 weeks.
- Primary Outcome Measures
Name Time Method Dropout and adherence rates T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Proportion of participants who adhered and withdrew from the study at the end of the intervention protocol. "Adherence to treatment" will be considered if the participant attends at least 12 sessions (75% of the total scheduled sessions).
Adverse events and adverse effects T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Proportion of participants that reported adverse events and adverse effects during the intervention protocol.
Practicality T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) The average time taken to assess secondary outcomes for each participant.
Acceptability T1: 8 weeks (post-intervention assessment) The degree to which participants approve of or are satisfied with the assessment and intervention protocols. Acceptability will be assessed qualitatively through focus groups, where a recorded interview (audio only) will be carried out by the study's main researcher, in order to assess the participants' perception of the study and the intervention protocol.
- Secondary Outcome Measures
Name Time Method Lower Limb Strength T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Five Times Sit to Stand Test
Grip Strength T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Hand-held dynamometer
Neuropathic pain components T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) painDETECT questionnaire - The instrument consists of 4 sections related to: (1) pain intensity in the last 4 weeks; (2) the pain pattern; (3) regions of pain; and (4) presence of neuropathic descriptors. The total score is obtained by adding the scores of the last 3 sections and can vary from 1 to 38. Scores ≤ 12 = the neuropathic mechanism is very unlikely to be present (predominance of the nociceptive mechanism); Scores ≥ 19 = there is a high probability of a predominant neuropathic mechanism; Scores \> 12 and \< 19 = the presence of a mixed component.
Fear of Movement T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Tampa Scale for Kinesiophobia - The instrument comprises 13 items rated on a 4-point Likert scale, as follows: (1) strongly disagree; (2) somewhat disagree; (3) somewhat agree; (4) strongly agree. The higher the score, the greater the fear perceived during the execution of the movement.
Temporal characteristics of pain T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) World Health Organization (WHO) Classification - It is a categorical variable with three different possible response categories:
* Episodic recurrent pain - recurrent pain attacks with pain-free intervals;
* Continuous pain - pain is always present;
* Continuous with pain attacks - recurrent pain flare-ups as exacerbations of ongoing underlying pain.Symptoms of Central Sensitization T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Central Sensitization Inventory (CSI)
Pressure Pain Threshold (Thenar region of the right hand; Right calcaneus; Region of greatest pain) T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Algometer
Pain severity T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Brief Pain Inventory (BPI)
Pain Catastrophizing T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Pain Catastrophizing Scale (PCS) - The instrument has 13 items subdivided into three different subscales: helplessness (items 1, 2, 3, 4, 5, and 12); magnification (items 6, 7, and 13); and rumination (items 8, 9, 10, and 11). All subscales are evaluated on a 5-point Likert scale, from 0 (not at all) to 4 (all the time), where higher scores represent a greater level of catastrophizing.
Cold and Warm Perception Threshold ((Thenar region of the right hand; Right calcaneus; Region of greatest pain) T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Q-sense
Agility and Dynamic Balance T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Timed-Up-And-Go Test
Nerve excursion (median and tibial nerves) T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Ultrasonography - The longitudinal and transverse excursion of the tibial and median nerves will be measured in millimeters using ultrasound images taken during the execution of a joint movement.
Range of Motion (ankle dorsiflexion and wrist extension) T0: baseline assessment; T1: 8 weeks (post-intervention assessment); T2: 3 months post-intervention (follow-up assessment) Goniometer
Trial Locations
- Locations (1)
University of Aveiro
🇵🇹Aveiro, Portugal