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Mechanical Interference Versus Neural Mobilization on Ulnar Neuropathy Post Cubital Tunnel Syndrome

Not Applicable
Not yet recruiting
Conditions
Cubital Tunnel Syndrome
Interventions
Other: Mechanical interference
Other: Neural mobilization
Other: conventional treatment
Registration Number
NCT05931731
Lead Sponsor
Cairo University
Brief Summary

this study will be conducted to compare between mechanical interference and neural mobilization on ulnar neuropathy post-cubital tunnel syndrome

Detailed Description

Ulnar nerve neuropathies are the second most common entrapment neuropathy of the upper extremities after carpal tunnel syndrome. Cubital tunnel syndrome (CTS) is a condition that involves pressure or stretching of the ulnar nerve also known as the "funny bone" nerve, which could cause numbness or tingling in the ring and tiny fingers, pain in the forearm, and hand weakness. The ulnar nerve runs in a groove on the inner side of the elbow. Conservative treatment of cubital tunnel syndrome is recommended for patients with mild and moderate symptoms and without changes in cutaneous sensation or muscle atrophy. In addition, a wide variety of conservative approaches including corticosteroid injections as a minimally invasive technique and splinting and bracing failure were recommended for CTS depending on its severity. Manual therapy techniques are part of the physical therapy treatment of CTS, which are classified into two groups including nerve mobilization and mechanical interface mobilization. The aim of the study was to find which manual therapy method-technique directed to mechanical interface and nerve mobilization-has superior beneficial effects on clinical and electrophysiological findings in the conservative management of patients with CTS. Ninety patients with post-cubital syndrome will be allocated randomly to three groups; the first experimental one will receive mechanical interference, the second experimental will receive neural mobilization and the third one will receive conventional treatment for four weeks.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
90
Inclusion Criteria
  • The patients were diagnosed and referred by an orthopedist.
  • The patient's age ranged from 20 to 55 years old.
  • Recent NCV for ulnar nerve confirming the diagnosis.
  • Unilateral cubital tunnel syndrome with ulnar neuropathy
Exclusion Criteria
  • Patients with cervical brachialgia.
  • Patients with metabolic diseases such as diabetes, severe thyroid disorders, anemia, and -pregnancy.
  • Hypertensive patients or patients who had a previous hand or elbow surgery.
  • Patients with median nerve involvement in proximal areas such as thoracic outlet syndrome.

History of carpal tunnel release surgery. Steroid injection

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Mechanical interferenceMechanical interferencethe patients will receive mechanical interference and conventional treatment three times a week for four weeks
Mechanical interferenceconventional treatmentthe patients will receive mechanical interference and conventional treatment three times a week for four weeks
Neural mobilizationNeural mobilizationthe patients will receive neural mobilization and conventional treatment three times a week for four weeks
Neural mobilizationconventional treatmentthe patients will receive neural mobilization and conventional treatment three times a week for four weeks
conventional treatmentconventional treatmentthe patients will receive conventional treatment only three times a week for four weeks
Primary Outcome Measures
NameTimeMethod
pain intensityup to four weeks

pain will be measured by visual analogue scale. it is a vertical or horizontal 100mm line graduated by different level of pain, starting from 0 (no pain) till 100 (worst pain).

Secondary Outcome Measures
NameTimeMethod
function and severityup to four weeks

Boston Questionnaire will be used for assessing the function and severity of hand. The questionnaire including two parts, namely the symptom severity scale (SSS) and the functional status scale (FSS), is considered a standard tool to evaluate the patients with CTS. The SSS contains 11 questions on different symptoms of hand and FSS comprises of 5 questions assessing the difficulty in performing selected activities. The response to each question was scored from one (mildest) to five (most severe) points. The overall scores for SSS and FSS were calculated as the score sum of all questions.

ulnar nerve motor distal latencyup to four weeks

electromyography device will be used for measuring ulnar nerve motor distal latency

ulnar nerve sensory conduction velocityup to four weeks

electromyography device will be used for measuring ulnar nerve sensory conduction velocity

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