Efficacy of Combining Movement Representation Techniques to Active Neural Mobilization in the Mechanosensitivity of the Median Nerve: A Pilot Study, Single-blind,Randomized, Crossover.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 10
- 试验地点
- 1
- 主要终点
- Elbow Extensor Range of Motion
研究概览
简要总结
The objective of this study will be to determine whether the combination of movement imaging techniques with neural mobilization (NM) exercises works to modify median nerve sensitivity to mechanical stimuli. Movement Representation Techniques (MRTs) are defined as therapeutic or training systems that neurophysiologically evoke a perceptual-cognitive representation of movement. They can be combined with the execution of actual movement or with afferent sensory stimulation (motor command). There is evidence demonstrating positive results in pain reduction and improved range of motion using MRTs alone.
The study will be evaluated in 10 randomly selected asymptomatic volunteers, considering the following variables: pressure pain threshold, elbow extensor range of motion, and sensory responses before and after the intervention, in both the experimental and control groups. The period between interventions will be 72 hours.
详细描述
The objective of this pilot study will be to determine the efficacy of combining movement representation techniques with neural mobilization (NM) exercises on median nerve mechanosensitivity. Movement representation techniques (MRTs) are defined as therapeutic or training systems that neurophysiologically evoke a perceptual-cognitive representation of movement through imagery or observation of motor actions. They can be combined with actual movement execution or with afferent sensory stimulation (motor command). There is evidence demonstrating positive results in pain reduction and range of motion gains using MRTs alone.
The study will be designed as a randomized, single-blind, crossover pilot clinical trial. In this study, 10 asymptomatic volunteers will be randomly selected and measured in the following variables: pressure pain threshold (PPT), elbow extensor range of motion (EROM), and the spatiotemporal distribution of pre- and post-intervention sensory responses in both the experimental group (RMM + MN) and the control group (MN). The washout period between interventions will be 72 hours.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Other
- 盲法
- Double (Investigator, Outcomes Assessor)
盲法说明
Evaluators
入排标准
- 年龄范围
- 18 Years 至 45 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •asymptomatic volunteers of both sexes
- •aged 18 to 45
- •with no symptoms or history of disease in the cervical region, shoulder girdle, or upper limb.
排除标准
- •history of surgery or trauma to the cervical spine, shoulder girdle, or upper limb;
- •nonspecific shoulder pain;
- •presenting symptoms of chronic pain in any region of the body;
- •aphantasia (inability to create mental images);
- •hypermobility;
- •history of cancer or active disease;
- •current infection;
- •rheumatological disease;
- •neurological and/or psychiatric disorders;
- •altered sensation;
- •current pregnancy;
- •consumption of centrally acting medications;
- •undergoing physiotherapy treatment in the last month;
- •inability to understand the informed consent document;
- •previous experience with median nerve provocation testing.
研究组 & 干预措施
Combination of Movement Representation Techniques with Neural Mobilization Exercises (experimental)
Combination of Movement Representation Techniques (Action observation, Motor imagery and Mirror therapy) with Neural Mobilization Exercises (Active neural mobilization of Median nerve)
干预措施: Combination of Movement Representation Techniques with neural mobilization exercises (Other)
Neural Mobilization Excercises (control)
Neural Mobilization Exercises (Active neural mobilization of Median nerve)
干预措施: Neural mobilization exercises (Other)
结局指标
主要结局
Elbow Extensor Range of Motion
时间窗: Pre- and post-interventions with a 72-hour washout period, for both control and experimental.
The elbow extension movement will be measured during the median nerve provocation test, through digital inclinometry of both the dominant and non-dominant arm by an experienced Physiotherapist.
Pressure Pain Threshold
时间窗: Pre and post interventions, both control and experimentalPre- and post-interventions with a 72-hour washout period, for both control and experimental.
Pressure pain thresholds (PPTs) will be performed at two sites, the dominant and non-dominant side, in asymptomatic participants: 1) the upper trapezius muscle, and 2) the proximal third of the forearm. A pressure algometer will be used. The device has a rod at one end with a 1 cm2 flat, circular rubber tip. Pressure will be applied progressively in a perpendicular direction at a rate of 0.5 kgf/cm2 per second to the assessment sites. Volunteers will be asked to verbally report the moment they feel the pressure exerted with the pressure algometer begin to change to a sensation of pain (first painful sensation). At that moment, the evaluator will stop applying pressure and a value will be obtained. Three measurements will be taken at each site, 30 seconds apart. The PPT will be determined as the arithmetic mean of the three measurements.
Spatiotemporal distribution of sensory responses
时间窗: Pre- and post-interventions with a 72-hour washout period, for both control and experimental.
Humanoid software (University Center of Assistance, Teaching and Investigation, CUADI, Argentina) will be used to evaluate the spatiotemporal distribution of pain intensity and/or perceived sensations. To mark the sensations that subject feel during the arm stretch test. To do this, the subjects will mark the area on the touchscreen where they perceive tension or stretching. The sensations will be representated by different colours: yellow is used for mild sensations, orange for moderate sensations, and red for intense sensations.
次要结局
未报告次要终点
研究者
Maximiliano Venosta
Physioterapist
University of Gran Rosario