Physical Therapy on Non-structural Medial Elbow Pain

NCT05537636 | Completed

• 1 other identifier: 60696
• Study Type: interventional
• Target: 22
• Locations: 1 country
• Sites: 1

Brief Summary

This study is investigating the effect of using a regional interdependence approach of managing non-structural elbow pain with physical therapy.

Conditions

Elbow Injuries and Disorders; Neuritis, Ulnar; Neuritis, Brachial; Neuritis; Nerve Root; Neuritis Median Nerve

Keywords

Regional Interdependence; Posture; Neural Tension; Physical Therapy

Outcome Measures

Primary Outcomes (3)

• Change in Cervical Range of Motion in extension

  Inclinometer measurement of cervical extension

  Baseline and every 5th visit up to discharge which is estimated to be 3 months on average

• Change in Focus On Therapeutic Outcome (FOTO) Patient Outcme Score

  Patient self-report of perceived level of function. Scores range from 0 = low function, to 100=high function.

  Baseline and every 5th visit up to discharge which is estimated to be 3 months on average

• Change in Lower Trapezius scapular muscle strength

  Objectively measure with hand held dynamometer for scapular retraction

  Baseline and every 5th visit up to discharge which is estimated to be 3 months on average

Secondary Outcomes (2)

• Change in Elbow Flexion Range of Motion in Ulnar Nerve Tension position

  Baseline and every 5th visit up to discharge which is estimated to be 3 months on average

• Change in Elbow Extension Range of Motion in Median Nerve Tension positoin

  Baseline and every 5th visit up to discharge which is estimated to be 3 months on average

Study Arms (1)

Regional Interdepence Intervention for the upper quarter

EXPERIMENTAL

Physical therapist will perform interventions to the entire uppper extremity and spine to treat elbow pain. Physical therapy intervention will include manual therapy and soft-tissue massage to the shoulder, cervical, and thoracic spine. Participants will be prescribed specific exercises using a phased approach.

Other: Rehabiltiation using exercise and manual therapy

Interventions

Rehabiltiation using exercise and manual therapy OTHER

A licensed Physical Therapist will provide manual therapy to help restore spinal and scapular mobility. In association with this patients will be prescribed home exercises using a phased approach. Phase 1 to gain mobility of the spine and scapular motor control Phase 2 to gain shoulder mobility to strengthen scapular and spine musculature Phase 3 shoulder strengthening with long lever arms.

Regional Interdepence Intervention for the upper quarter

Eligibility Criteria

• Age: 15 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• The patient presents with elbow pain that is not exacerbated with resisted wrist flexion, extension, supination, or pronation.
• The patient presents with elbow pain that is not exacerbated with passive wrist flexion or extension.
• The patient presents with three of the four positive cervical radicular signs
• Patient presents with peripheral paresthesia

You may not qualify if:

• The patient reports a surgical history involving the elbow.
• The patient has an MRI that is positive for structural deficits within the upper extremity.
• The patient self-reports a diagnosis of rheumatoid arthritis or other neurological systemic diseases such as Parkinson's disease, cerebrovascular accident, multiple sclerosis, or similar conditions

Sponsors & Collaborators

• Timothy Uhl: lead
• Bluegrass Orthopedics: collaborator

Study Sites (1)

Bluegrass Orthopaedics

Lexington, Kentucky, 40509, United States

Location

Related Publications (5)

• Sueki DG, Cleland JA, Wainner RS. A regional interdependence model of musculoskeletal dysfunction: research, mechanisms, and clinical implications. J Man Manip Ther. 2013 May;21(2):90-102. doi: 10.1179/2042618612Y.0000000027.

  PMID: 24421619 RESULT

• Wickstrom BM, Oakley PA, Harrison DE. Non-surgical relief of cervical radiculopathy through reduction of forward head posture and restoration of cervical lordosis: a case report. J Phys Ther Sci. 2017 Aug;29(8):1472-1474. doi: 10.1589/jpts.29.1472. Epub 2017 Aug 10.

  PMID: 28878485 RESULT

• Day JM, Willoughby J, Pitts DG, McCallum M, Foister R, Uhl TL. Outcomes following the conservative management of patients with non-radicular peripheral neuropathic pain. J Hand Ther. 2014 Jul-Sep;27(3):192-9; quiz 200. doi: 10.1016/j.jht.2014.02.003. Epub 2014 Feb 27.

  PMID: 24685569 RESULT

• Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine (Phila Pa 1976). 2003 Jan 1;28(1):52-62. doi: 10.1097/00007632-200301010-00014.

  PMID: 12544957 RESULT

• Nee RJ, Jull GA, Vicenzino B, Coppieters MW. The validity of upper-limb neurodynamic tests for detecting peripheral neuropathic pain. J Orthop Sports Phys Ther. 2012 May;42(5):413-24. doi: 10.2519/jospt.2012.3988. Epub 2012 Mar 8.

  PMID: 22402638 RESULT

MeSH Terms

Conditions

Elbow Injuries; Disease; Ulnar Neuropathies; Brachial Plexus Neuritis; Neuritis

Interventions

Musculoskeletal Manipulations

Condition Hierarchy (Ancestors)

Arm Injuries; Wounds and Injuries; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Mononeuropathies; Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Brachial Plexus Neuropathies

Intervention Hierarchy (Ancestors)

Complementary Therapies; Therapeutics; Physical Therapy Modalities; Rehabilitation

Study Officials

• Tim L Uhl, PhD

  University of Kentucky

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Professor

Model Details: Cohort longitudinal

Study Record Dates

• First Submitted: August 11, 2022
• First Posted: September 13, 2022
• Study Start: October 1, 2022
• Primary Completion: August 30, 2023
• Study Completion: August 30, 2023
• Last Updated: November 22, 2023

Record last verified: 2023-11

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)