Median Nerve Excursion During Neurodynamic Mobilization

NCT03970408 | Completed

• 1 other identifier: HMahmoud
• Study Type: observational
• Target: 18
• Locations: 1 country
• Sites: 2

Brief Summary

This study will compare changes in longitudinal median nerve excursion when neck flexion and ipsilateral rotation are added to the standard Median neurodynamic test1 (MNT1) position in patients with carpal tunnel syndrome (CTS) and normal controls.

Conditions

CTS

Keywords

Median nerve,; Carpal tunnel syndrome; Neurodynamic mobilization

Outcome Measures

Primary Outcomes (2)

• Changes in longitudinal median nerve excursion with neck flexion

  Changes in median nerve excursion, as measured by ultrasonography, when the neck is moved toward flexion combined with the standard MNT1

  One day

• Changes in longitudinal median nerve excursion with ipsilateral neck rotation

  Changes in median nerve excursion changes, as measured by ultrasonography, when the neck is moved in ipsilateral rotation combined with the standard MNT1

  One day

Study Arms (2)

Carpal tunnel syndrome

Patients with CTS who fulfill the following eligibility criteria: Inclusion criteria * Females and male patients referred with a CTS diagnosis confirmed by nerve conduction studies and positive Tinel and Phalen tests. * Age ranging from 30-50 years old. * The selected patient will be able to tolerate the entire standard neurodynamic technique. Exclusion criteria * Symptoms referred to the neck. * Sever CTS * More than 10% limitation of neck flexion, rotation, and side bending ranges. * History of disease, trauma, or surgery to neck, thorax, or upper limbs. * Presence of peripheral neuropathy or cervical radiculopathy. * History of systemic disease associated with neuropathies such as diabetes mellitus, connective tissue diseases, thyroid disease, or obesity.

Procedure: MNT1

Healthy control

Asymptomatic healthy age-matched control with no symptoms or history of upper quadrant disease, dysfunction, trauma or surgery.

Procedure: MNT1

Interventions

MNT1 PROCEDURE

Participants will in supine. Arm will be position in standard MNT1. Shoulder, elbow, wrist and fingers will be maintained in the required position using a costumed splint throughout all testing. All movements will be limited to the range where pain or other symptoms are not provoked. Passive neck flexion and rotation will be added to MNT1 and will be applied as tensioning movements at level 3. All movements will be repeated three times and an average will be calculated. Myrin goniometer will be used to assess neck flexion and rotation. The movements order will be randomized using excel random generation function. Movements will be done by a single trained therapist. The end position will be held up to 10 seconds until median nerve excursion is recorded by US. For US capturing, the transducer will be positioned perpendicularly and aligned longitudinally with the median nerve at the wrist. Assessor will be blinded to participants grouping.

Also known as: Neurodynamic tension test

Carpal tunnel syndrome; Healthy control

Eligibility Criteria

• Age: 30 Years - 50 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Patients will be selected from primary care clinics.

You may qualify if:

• Clinical diagnosis of mild to moderate CTS.
• Must be able to tolerate the entire standard MNT1 position.

You may not qualify if:

• Severe CTS.
• Symptoms referred to the neck.
• Limited neck flexion, rotation, and side bending ranges (\>10%).
• History of upper quadrant trauma, dysfunction or surgery.
• History of peripheral neuropathy or cervical radiculopathy.
• History of systemic disease associated with neuropathies such as diabetes mellitus, connective tissue diseases, thyroid disease, or obesity.

Sponsors & Collaborators

• Aliaa Rehan Youssef: lead

Study Sites (2)

Ain Shamas University

Cairo, Egypt

Location

Cairo University Hospital

Cairo, Egypt

Location

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MeSH Terms

Conditions

Carpal Tunnel Syndrome

Condition Hierarchy (Ancestors)

Median Neuropathy; Mononeuropathies; Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Nerve Compression Syndromes; Cumulative Trauma Disorders; Sprains and Strains; Wounds and Injuries

Study Officials

• Aliaa Rehan Youssef, Phd

  Cairo University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Associate professor of Orthopedic Physical Therapy

Study Record Dates

• First Submitted: May 25, 2019
• First Posted: May 31, 2019
• Study Start: May 1, 2019
• Primary Completion: September 1, 2020
• Study Completion: December 1, 2020
• Last Updated: July 28, 2021

Record last verified: 2020-07

Locations

EG (2)