Low Level Laser Versus Neural Mobilization of Brachial Plexus on Shoulder Dysfunction Post Liver Donation
- Conditions
- Shoulder Pain
- Registration Number
- NCT06703775
- Lead Sponsor
- Cairo University
- Brief Summary
The purpose of the study will be to compare therapeutic effect of low level laser versus neural mobilization techniques on shoulder dysfunction post liver donation.
- Detailed Description
The need for this study develops from the lack of information in the published studies about the effectiveness of low level laser and neural mobilization of brachial plexus on shoulder dysfunction post liver donation.
Following liver donation and transplantation, shoulder dysfunction and discomfort occur in 20% to 60% of patients.
Low-level laser therapy (LLLT) has been used as a non-pharmacological alternative to treat painful musculoskeletal conditions. It is used in acute, chronic painful and inflammatory affections shows that low energy irradiation from lasers alters cellular processes, producing anti-inflammatory effects and increased collagen turnover.
Neural mobilization (NM) is an intervention aimed at restoring the homeostasis in and around the nervous system, by mobilization of the nervous system itself or the structures that surround the nervous system. Neural mobilization facilitates movement between neural structures and their surroundings (interface) through manual techniques or exercise. Human and animal studies revealed that NM reduces intraneural edema, improves intraneural fluid dispersion, reduces thermal and mechanical hyperalgesia and reverses the increased immune responses.
The present study is designed to investigate the effect of LLLT versus NMT on shoulder dysfunction post liver donation.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 66
- Patients are both males and females.
- Their age will range from (20-50) years.
- Patients will suffer from unilateral shoulder pain(Rt shoulder).
- Patients will begin the training program one week post.operative.
- All patients will suffer from moderate to severe pain (VAS score > 4).
- Patients will be given their informed consent.
- Known history of high level Spinal cord injury and malignancy
- Metabolic disease with a neurological component such as diabetes.
- Orthopedic disorders such as fracture or dislocation.
- Musculoskeletal disorders that will impair performance during training and tests.
- Uncontrolled cardiovascular or pulmonary diseases .
- Circulatory disturbances of upper extremity
- Psychiatric illness, severe behavior or cognitive disorders.
- Uncooperative patients.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Arabic version of Shoulder Pain and Disability Index (SPADI) 4 weeks The SPADI is a self-reported questionnaire with 13 items divided into two subscales: pain and disability. The pain subscale includes five questions about pain intensity during specific activities, such as lying on the involved side, reaching for a high shelf, or pushing with the involved arm. The disability subscale has eight questions about difficulty with tasks like washing hair, putting on clothing, or carrying a 10-pound object. Each question is rated on an 11-point scale (0-10). Scores are summed, converted to percentages, and averaged to provide a total SPADI score ranging from 0 (best) to 100 (worst). SPADI will be assessed pre- and post-treatment (4 weeks).
- Secondary Outcome Measures
Name Time Method Measurement of shoulder abduction range of motion (ROM) 4 weeks It will be measured from supine lying position, using a digital goniometer. The starting position for the participant's arm will be laterally rotated beside his body with the elbow extended and palm facing upward without flexion or extension of shoulder. The axis of measurement will be the anterior aspect of the acromion process and the medial epicondyle as the reference point. The fixed arm will be placed parallel to the surface of the floor, the movable arm will be placed parallel to the anterior aspect of the upper arm (humerus).
Measurement of shoulder external rotation range of motion (ROM) 4 weeks It will be measured from supine lying position, using a digital goniometer. The starting position for the participant's arm was abducted 900 and elbow flexed 90° with the forearm perpendicular on the plinth, with his palm facing toward his feet without forearm pronation or supination and elbow outside plinth, a small pad was used under the humerus to be in level with the acromion. The distal end of humerus, thorax, and clavicle was stabilized. The axis of measurement was the olecranon process, and the ulnar styloid process as the reference point.
Measurement of shoulder flexion range of motion (ROM) 4 weeks It will be measured from supine lying position, using a digital goniometer. The starting position for the participant's arm will be beside his body with the elbow extended and the thumb pointing upward. The axis of measurement will be the lateral part of greater tubercle and the lateral epi-condyle as the reference point. The fixed arm will be placed parallel to the surface of the floor, the movable arm will be placed parallel to the lateral aspect of the upper arm (humerus).
Measurement of maximum isometric force (MIF) of shoulder abductors 4 weeks The maximum isometric force (MIF) of shoulder abductors will be measured before and after treatment period using Lafayette hand-held dynamometer. The MIF will be measured through an accommodating isometric "make" test, where participants applied maximal force against the examiner while a steady position was maintained. Participants will perform three, 5 seconds contractions for each muscle group with a 30 second rest after each trial and 5 minutes rest between muscle groups. The average force of the three testing trials will be computed for each muscle. The examiner encourages participants to do their best effort during measurement.
Trial Locations
- Locations (1)
faculty of physical therapy, Cairo University
🇪🇬Giza, Egypt