Effectiveness of Neurodinamic Techniques on Radial Nerve for the Treatment of Lateral Epicondylalgia

NCT06468514 | Not Yet Recruiting DMC

• 1 other identifier: TECHNIQUES ON RADIAL NERVE
• Study Type: interventional
• Target: 64
• Locations: 1 country
• Sites: 1

Brief Summary

Lateral elbow pain is a prevalent musculoskeletal disorder in the working population due to overuse of the upper limb. This pathology has serious consequences for health, work performance and overall health burden. In this injury, as in any musculoskeletal disorder, the peripheral nervous system is involved. Because of its course and corresponding motor and sensory innervation in the area, the radial nerve should be taken into consideration as a structure involved in elbow pain. The aim of the present study is to demonstrate which of the neurodynamic techniques is more effective in lateral epicondylalgia, neural tension techniques or neural mobilization techniques.

Conditions

Lateral Epicondylitis \(Tennis Elbow\)

Keywords

Epicondylalgia Neural mobilization Neural tension Physiotherapy Radial nerve

Outcome Measures

Primary Outcomes (1)

• Grip strength

  his is a continuous quantitative variable. The measurement of grip strength is performed with the subject in a chair with backrest and armrests, his shoulder is in neutral position, and in adduction; the elbow in 90º flexion and the wrist in 30º extension. Participants are asked to perform maximal grip strength with the dynamometer in a self-selected grip position for 6 seconds. According to the American Society of Hand Therapists Guide, a Jamar® hydraulic dynamometer (Lafayette Instrument Company, USA) is used. The measurements were repeated 3 times, with an interval of 1 minute and the mean of the 3 measurements was used for statistical analysis.

  the duration of the program will be 6 weeks, with two sessions per week with 72 hours of rest between sessions. A total of 12 sessions will be carried out. A re-evaluation will be done 4 weeks after the final evaluation and another one after 24 weeks.

Secondary Outcomes (3)

• Pain on pressure

  the duration of the program will be 6 weeks, with two sessions per week with 72 hours of rest between sessions. A total of 12 sessions will be carried out. A re-evaluation will be done 4 weeks after the final evaluation and another one after 24 weeks.

• global pain

  the duration of the program will be 6 weeks, with two sessions per week with 72 hours of rest between sessions. A total of 12 sessions will be carried out. A re-evaluation will be done 4 weeks after the final evaluation and another one after 24 weeks.

• DASH QUESTIONARY

  the duration of the program will be 6 weeks, with two sessions per week with 72 hours of rest between sessions. A total of 12 sessions will be carried out. A re-evaluation will be done 4 weeks after the final evaluation and another one after 24 weeks.

Study Arms (2)

GRUPO 1

EXPERIMENTAL

a Neural tension technique on the radial nerve will be performed.

Other: neural tensioning technique on radial nerve

GRUPO 2

EXPERIMENTAL

A neural gliding technique will be performed on the radial nerve.

Other: Sliding technique on radial nerve

Interventions

neural tensioning technique on radial nerve OTHER

the neural group tensioning technique: The test should be performed in approximately 10° of shoulder abduction. The examiner extends the elbow 2 seconds just to the range where the patient notices tension but no pain and then the elbow is flexed. Three sets of 6-8 swings are performed with 1 minute rest in between.

GRUPO 1

Sliding technique on radial nerve OTHER

The mobilization maneuver begins by identifying the first resistance and the range of extension associated with pain. Maintaining elbow extension within the elastic region of resistance free of pain and/or paresthesia the examiner increases elbow extension and simultaneously allows the wrist to extend as necessary for the radial nerve branches in the forearm to glide proximally. The physical therapist then flexes the wrist while allowing the elbow to flex to cause the radial nerve excursion distally in the forearm.

GRUPO 2

Eligibility Criteria

• Age: 30 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patient diagnosed with lateral epicondylalgia.
• Experiencing elbow pain of 2 to 6 months duration.
• Age between 30 and 60 years old.
• Radial humeral joint tenderness to palpation.
• Positive Cozen\'s test

You may not qualify if:

• \- Bilateral symptoms.
• Rheumatologic disease involving the elbow and wrist
• Musculoskeletal disorder due to connective tissue pathology
• Cervical radiculopathy
• Nerve compression including the upper extremity
• Operation on the affected arm
• Having received treatment for epicondylalgia in the last 6 months
• Radiating pain from the cervical spine
• Instability of the external ligamentous complex of the elbow(3).
• Not having received any physiotherapy session in the month prior to the start of the study.
• Neural clinical manifestations (electric shock-like pain, tingling, tingling, numbness and/or burning).

Sponsors & Collaborators

• University of Alcala: lead

Study Sites (1)

Campus Científico Tecnológico. Av. de León. 3A

Alcalá de Henares, Madrid, 28805, Spain

Location

Related Publications (5)

• Gamelas T, Fernandes A, Magalhaes I, Ferreira M, Machado S, Silva AG. Neural gliding versus neural tensioning: Effects on heat and cold thresholds, pain thresholds and hand grip strength in asymptomatic individuals. J Bodyw Mov Ther. 2019 Oct;23(4):799-804. doi: 10.1016/j.jbmt.2019.04.011. Epub 2019 Apr 24.

  PMID: 31733764 BACKGROUND

• Ellis R, Carta G, Andrade RJ, Coppieters MW. Neurodynamics: is tension contentious? J Man Manip Ther. 2022 Feb;30(1):3-12. doi: 10.1080/10669817.2021.2001736. Epub 2021 Nov 16.

  PMID: 34781843 BACKGROUND

• Yilmaz K, Yigiter Bayramlar K, Ayhan C, Tufekci O. Investigating the effects of neuromobilization in lateral epicondylitis. J Hand Ther. 2022 Jan-Mar;35(1):97-106. doi: 10.1016/j.jht.2020.11.003. Epub 2020 Nov 13.

  PMID: 33563509 BACKGROUND

• Arumugam V, Selvam S, MacDermid JC. Radial nerve mobilization reduces lateral elbow pain and provides short-term relief in computer users. Open Orthop J. 2014 Oct 17;8:368-71. doi: 10.2174/1874325001408010368. eCollection 2014.

  PMID: 25352930 BACKGROUND

• Taylor A, Wolff AL. The forgotten radial nerve: A conceptual framework for treatment of lateral elbow pain. J Hand Ther. 2021 Apr-Jun;34(2):323-329. doi: 10.1016/j.jht.2021.05.009. Epub 2021 Jun 27.

  PMID: 34193382 BACKGROUND

MeSH Terms

Conditions

Tennis Elbow

Condition Hierarchy (Ancestors)

Elbow Tendinopathy; Tendinopathy; Muscular Diseases; Musculoskeletal Diseases; Elbow Injuries; Arm Injuries; Wounds and Injuries; Tendon Injuries

Study Officials

• María Balsa-Amarante, MSc

  University of Alcalá

  PRINCIPAL INVESTIGATOR

Central Study Contacts

María Balsa-Amarante, MsC

CONTACT

34654050051; maria.balsa@edu.uah.es

Tomás Gallego Izquierdo, PhD

CONTACT

+34626473650; tomas.gallego@uah.es

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PT

Study Record Dates

• First Submitted: June 15, 2024
• First Posted: June 21, 2024
• Study Start: August 24, 2024
• Primary Completion: March 24, 2025
• Study Completion: April 15, 2026
• Last Updated: June 25, 2024

Record last verified: 2024-06

Data Sharing

• IPD Sharing: Will not share

Locations

ES (1)