Effectiveness of Slider and Tensioner Neurodynamic Mobilization Techniques in Patients With Cervical Radiculopathy: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 36
- 试验地点
- 1
- 主要终点
- Visual Analogue Scale
研究概览
简要总结
The goal of this randomized controlled trial is to investigate the effects of adding slider neural mobilization technique compared to tensioner neural mobilization technique to conventional physical therapy treatment on pain, function, cervical range of motion, hand grip strength, and electrophysiological parameters of the median nerve in patients with cervical radiculopathy.
详细描述
Cervical radiculopathy (CR) is a condition where the nerve root of a spinal nerve is compressed or impaired, causing the pain and symptoms to spread beyond the neck, radiating to the shoulder, and upper limb. Cervical radiculopathy primarily results from an impingement and inflammation of a nerve root induced by a space-occupying lesion that reduces the size of the intervertebral foramen, as a degenerative lesion of the zygapophyseal joint, or it is associated with a cervical disc derangement.
Patients presenting with CR complain of neck, periscapular, and radicular pain into the hand and arm. As well as neurologic symptoms such as sensory disturbances (paresthesia or numbness), muscle weakness with reduced tendon reflexes in the affected nerve root, or a combination of these signs and symptoms.
The reported annual incidence of CR is 85 cases per 100,000 people in the population, while the prevalence is 3.5/1000 persons. The C7 nerve root is most frequently impacted, with more than half of all cases affecting this level.
Several studies utilized therapeutic exercises, manual therapy, other modalities, cervical collars, cervical traction, postural education, and different medications such as drugs and steroid injections in the conservative management for cervical radiculopathy in its different stages.
The neural mobilization (NM) is a manual therapy method that improves neural flexibility, lowers dynamic sensitivity of the nervous system, increases blood flow, and relieves pain; for that, improved neural mobility and alleviated pain increase joint range of motion (ROM).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 30 Years 至 50 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Current continuous or intermittent pain that has persisted for more than 3 months.
- •Motor, reflex, and/or sensory changes in the upper limb.
- •Both genders aged 30-50 years.
- •Three positive special tests out of five as a predefined diagnostic criterion from the following tests: Upper Limb Neural Tension A (ULNT) test for the median nerve, Spurling's test, compression test, cervical distraction test, less than 60° cervical rotation towards the symptomatic side, and Valsalva maneuver.
- •A motor nerve conduction study, F wave, and H reflex were performed in the involved limb to confirm CR.
排除标准
- •History of surgical procedures for cervical or upper extremity.
- •Clinical signs or symptoms of medical red flags (infection, cancer, and cardiac involvement).
- •Patients with neck pain for signs and symptoms of serious pathology, upper cervical ligamentous insufficiency, unexplained cranial nerve dysfunction, and spinal fractures.
- •Any systematic disease such as rheumatism and tuberculosis, cervical myelopathy, or multiple sclerosis.
- •Systemic disease is known to cause generalized peripheral neuropathy, such as diabetes mellitus.
- •Complete loss of sensation along the involved nerve root.
- •Upper limb compression syndrome, such as thoracic outlet syndrome, carpal tunnel syndrome, and pronator syndrome.
- •Pregnant woman.
- •Patients who have received any physical therapy of the cervical region in the past 3 months.
研究组 & 干预措施
Control group A (conventional treatment)
Conventional treatment, including hot pack, stretching of the neck muscles, cervical isometrics exercise.
干预措施: Conventional treatment (Other)
Experimental group B (Tensioning neural mobilization with addition to conventional treatment)
Median nerve neural tensioning mobilization with addition to conventional treatment
干预措施: Tensioner Neuro Dynamic Mobilization (Other)
Experimental group C (Sliding neural mobilization with addition to conventional treatment)
Median nerve sliding neural mobilization with addition to conventional treatment
干预措施: Slider Neuro Dynamic Mobilization (Other)
结局指标
主要结局
Visual Analogue Scale
时间窗: At baseline, to the end of treatment at 4 weeks.
to measure neck pain with score extended from 0 to 10, minimum score 0 (no pain), highest score 10 (worst pain).
The Arabic Version Of Neck Disability Index
时间窗: At baseline, to the end of treatment at 4 weeks.
to assess the level of disabilities in patients with neck pain, in % points.
Cervical Range of Motion
时间窗: At baseline, to the end of treatment at 4 weeks.
to measure the full cervical rotation using CROM device in degrees
Hand Grip Strength
时间窗: At baseline, to the end of treatment at 4 weeks.
to measure hand grip strength using hydraulic dynamometer, in kilogram.
Nerve Conduction Study
时间窗: At baseline, to the end of treatment at 4 weeks.
Motor conduction study for the median nerve, to measure conduction velocity (m/second), distal latency (ms), and amplitude(mV).
F wave
时间窗: At baseline, to the end of treatment at 4 weeks.
F wave for the median nerve to measure latency (ms).
H-Reflex
时间窗: At baseline, to the end of treatment at 4 weeks.
H-Reflex for the median nerve to measure latency (ms), amplitude (mV), H-R ratio (%).
次要结局
未报告次要终点
研究者
Hiba Mohammad Hasan
Principal Investigator
Cairo University