Effects of Neural Tension Versus Neural Sliding Technique on Cervical Radiculopathy.

NCT05959330 | Completed

• 1 other identifier: RiphahIU Sehar Fatima
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this research is to find the effects of neural tension versus neural sliding technique on pain, cervical muscle endurance and hand grip strength in unilateral cervical radiculopathy. It will be a randomized controlled trial in which participants selected through non probability convenience sampling with age from 18 to 65 years having unilateral cervical radicular pain in upper limb since 3 months and any two of the following positive test Spurling's test, Distraction test and Upper Limb Tension Test. Participants will be randomly allocated, into three groups (A, B, and C). On the contrary, patients with any orthopedic or neurological conditions of cervical spine and shoulder joint, malignancy, cervical surgeries and bilateral cervical radiculopathies will be excluded from the study. Baseline measurement of all groups will be taken by using Numerical Pain Rating Scale (NPRS) for pain, Cranio-cervical Flexion Test for endurance and Hand-Held Dynamometer for hand grip strength. Group A will receive 7 neural tension technique, Group B will receive neural sliding technique, while Group C will receive both neural tension technique and neural sliding technique for 4 weeks (6 successive sessions). Both techniques (slider and tensioner) will be provided three sets in every session; Each set will be performed in a slow, oscillatory manner with 10 seconds rest between the sets. Posttest measurement will be taken after 4 weeks of treatment. SPSS 21 software will be used for data entry and analysis.

Conditions

Cervical Radiculopathy

Keywords

Slider; Tensioner Neurodynamic Mobilization; Cervical Radiculopathy; Hand Grip Strength; Numeric Pain Rating Scale

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating Scale

  Numeric Pain Rating Scale is a subjective outcome measure tool that is used to measure intensity of pain in adults. It is a numeric version of Visual Analogue Scale. NPRS is a unidirectional 11- point scale that ranges from 0 to 10. With "0" indicating the 'no pain at all' and "10" indicating the 'the worst pain imaginable'. The NPRS can be administered either graphically or verbally. The respondent is asked to indicate the numeric value that describes their current pain intensity best

  Changes from baseline Numeric Pain Rating Scale (NPRS) at 1 months

• Hand-Held Dynamometer

  The patient will be asked to sit on a straight back chair with his/her feet flat on the floor. The affected shoulder was to be maintained at 0º of flexion, abduction and rotation, elbow flexed to 90º, forearm rested in a neutral position with the wrist in minimal extension and ulnar deviation. On achieving the standardized arm position, the dynamometer set at the second handle space was given to subjects who were then advised to perform 3 maximum gripping efforts for 5 seconds. A 15 second rest period was given to prevent fatigue effects. While performing each trial, each patient was instructed by the assessor as follows: "Squeeze the handle as hard as possible". The mean value of the 3 efforts (measured in pounds) was evaluated for the analysis of grip strength. The patients were not allowed to see their score in each trial. No visual and verbal encouragement was given for achieving the maxi-mum capable grip strength

  Changes from baseline Hand-Held Dynamometer (HHD) at 1 months

• Cervico-cranial Flexion Test (Blood Pressure Cuff)

  A blood pressure cuff is inflated to 20 mmHg and is placed between the lordotic curve and the surface of the table. While keeping the back of the head stable, the patient performs cranial cervical flexion in a graded fashion in 5 increments (22, 24, 26, 28, and 30 mmHg). Each position is held for 10 seconds with 10 seconds rest between increments. The cranial cervical flexion is performed by a head nod in the upper cervical spine. Make sure the patient's jaw is relaxed, so that there is no platysma, hyoid muscle, or sternocleidomastoid recruitment. The test is ended when the pressure decreases \>20% or when substitution occurs during the head nod. Normal response is achieving 26-30 mmHg.\[

  Changes from baseline Cervico-cranial Flexion Test (CCFT) at 1 months

Study Arms (3)

Neural Tension Technique(ulnar, median, radial)

EXPERIMENTAL

Neural Tension Technique for 4 weeks (6 successive sessions). Three sets will be provided in every session; Each set will be performed in a slow, oscillatory manner with 10 seconds rest between the sets. Posttest measurement will be taken after 4 weeks of treatment

Other: Neural Tension Technique(ulnar, median, radial)

Neural Slider Technique (ulnar, median, radial)

EXPERIMENTAL

Neural Slider Technique for 4 weeks (6 successive sessions). Three sets will be provided in every session; Each set will be performed in a slow, oscillatory manner with 10 seconds rest between the sets. Posttest measurement will be taken after 4 weeks of treatment

Other: Neural Slider Technique (ulnar, median, radial)

Neural Tension Technique and Neural Sliding Technique(ulnar, median, radial)

EXPERIMENTAL

Neural Tension and Sliding Technique for 4 weeks (6 successive sessions). Three sets will be provided in every session; Each set will be performed in a slow, oscillatory manner with 10 seconds rest between the sets. Posttest measurement will be taken after 4 weeks of treatment

Other: Neural Tension Technique and Neural Sliding Technique(ulnar, median, radial)

Interventions

Neural Tension Technique(ulnar, median, radial) OTHER

Neural Tension Technique for 4 weeks (6 successive sessions). Three sets will be provided in every session; Each set will be performed in a slow, oscillatory manner with 10 seconds rest between the sets. Posttest measurement will be taken after 4 weeks of treatment

Neural Tension Technique(ulnar, median, radial)

Neural Slider Technique (ulnar, median, radial) OTHER

Neural Slider Technique for 4 weeks (6 successive sessions). Three sets will be provided in every session; Each set will be performed in a slow, oscillatory manner with 10 seconds rest between the sets. Posttest measurement will be taken after 4 weeks of treatment

Neural Slider Technique (ulnar, median, radial)

Neural Tension Technique and Neural Sliding Technique(ulnar, median, radial) OTHER

Neural Tension and Sliding Technique for 4 weeks (6 successive sessions). Three sets will be provided in every session; Each set will be performed in a slow, oscillatory manner with 10 seconds rest between the sets. Posttest measurement will be taken after 4 weeks of treatment

Neural Tension Technique and Neural Sliding Technique(ulnar, median, radial)

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Unilateral radicular pain in upper limb since 3 months(10)
• Any two of the following tests positive: Spurling's test, Distraction test, Upper Limb Tension Test

You may not qualify if:

• Any orthopedic or neurological conditions of cervical spine and shoulder joint
• Hypermobility of cervical spine
• Malignancy
• Vertebro-basilar insufficiency
• Patients undergone cervical surgeries
• Patients with bilateral cervical radiculopathies

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Service Hospital Lahore

Lahore, 54000, Pakistan

Location

Related Publications (1)

• Kang KC, Lee HS, Lee JH. Cervical Radiculopathy Focus on Characteristics and Differential Diagnosis. Asian Spine J. 2020 Dec;14(6):921-930. doi: 10.31616/asj.2020.0647. Epub 2020 Dec 22.

  PMID: 33373515 BACKGROUND

MeSH Terms

Conditions

Radiculopathy

Condition Hierarchy (Ancestors)

Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases

Study Officials

• Sehar Fatima, DPT

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 31, 2023
• First Posted: July 25, 2023
• Study Start: March 5, 2023
• Primary Completion: July 15, 2023
• Study Completion: July 30, 2023
• Last Updated: December 27, 2023

Record last verified: 2023-12

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)