Effectiveness of the Neural Mobilization on Upper Limb Functionality in Patients With Acquired Brain Injury

Not Applicable

Completed

• Conditions: Acquired Brain Injury; Hemiplegia and Hemiparesis
• Interventions: Other: Neurodynamic; Other: Mimic group

• Registration Number: NCT04652934
• Lead Sponsor: Vanesa Abuín

Brief Summary

The main objective:

To determine changes in physiological and structural properties of upper limb muscles with spasticity in patients with acquired brain injury after applying neural mobilization improving their functional performance, their participation in society and quality of life.

Hypothesis:

Peripheral nerve mobilizations performed with neurodynamic techniques in upper limb in patients with acquired brain injury, generate changes at structural and physiological level, favoring the performance of daily life activities and improving the quality of life.

Detailed Description

Randomized clinical trial with blinding of the subject, the evaluator and the person analyzing the data.

In the experimental group will be performed neural mobilitazion technique, while in the sham a technique to mimic neurodynamic.

The assessment will be made by a single evaluator.

Study Timeline

• Study First Submitted: 2020-10-08
• Study First Submitted QC: 2020-11-26
• Study First Posted: 2020-12-03
• Study Start: 2022-01-26
• Status Verified: 2023-07
• Primary Completion: 2023-07-28
• Study Completion: 2023-07-28
• Last Update Submitted: 2023-07-28
• Last Update Posted: 2023-08-01

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 24

Inclusion Criteria

• Diagnosis of acquired brain injury (hemiplegia-hemiparesis)
• Ages between 25 and 50 years

Exclusion Criteria

• Unable to understand and respond to verbal instructions
• Absence of voluntary movement in the upper limb
• Take medicine for spasticity
• Botulinum toxin infiltration in the last 6 months

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention group	Neurodynamic	The Upper Limb Neurodynamic Test (ULNT1) technique described by Butler will be performed on the affected limb. This technique consists of performing shoulder depression, 90º shoulder abduction, hand, wrist and forearm in a neutral position, external rotation of the shoulder and extension of the elbow. After positioning the limb in this position, wrist flexion-extension movements will be performed smoothly and rhythmically of 20 movements every minute, for 3 minutes, three times per session with 1 minute of rest between each series.
Mimic group	Mimic group	The protocol used by Beneciuk et al. Will be used. This intervention consists of imitating NM without stressing the nervous system. It will be carried out as follow: a neutral cervical position will be maintained (0º of cervical inclination), 45º of shoulder abduction without depression, 45º of external rotation of the shoulder combined with 45º of elbow flexion with the forearm in pronation. Afterwards, 10 wrist flexion-extension movements will be performed at a rate of 6 seconds per cycle (3 seconds of flexion and 3 seconds of extension). The resistance that you will feel will stabilize when you change motion. Once the 10 cycles of movements have been carried out, a wrist flexion will be maintained for 10 seconds.

Primary Outcome Measures

Name	Time	Method
Changes in Muscle Strength	Pre-intervention; Immediately after the intervention; Follow up (1 week after the intervention)	Dynamometer
Changes in Upper Limb Pain to Pressure	Pre-intervention; Immediately after the intervention; Follow up (1 week after the intervention)	Algometer
Changes in Manual Ability	Pre-intervention; Immediately after the intervention; Follow up (1 week after the intervention)	Abilhand Scale; Score 0(worse outcome)-2(better outcome)
Changes in Muscle Spasticity	Pre-intervention; Immediately after the intervention; Follow up (1 week after the intervention)	MAS (Modified Ashworth Scale) 0 (better outcome) - 4 (worse outcome)
Changes in Nervous Conduction	Pre-intervention; Immediately after the intervention; Follow up (1 week after the intervention)	Delsys Trigno Avanti (surface eMG for non-invasive assessment of muscles)
Changes in Upper Limb Pain Perception	Pre-intervention; Immediately after the intervention; Follow up (1 week after the intervention)	EVA (Visual Analog Scale) 0 (worse outcome) - 10 (better outcome)

Trial Locations

Locations (1)

Federico Salniccia; 🇪🇸 Madrid, Spain