Median Nerve Excursion During Neurodynamic Mobilization

Aliaa Rehan Youssef

Status: Completed

Conditions: CTS

Treatments: Procedure: MNT1

Study type: Observational

Funder types: Other

Identifiers

NCT03970408

HMahmoud

Details and patient eligibility

About

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.

Full description

Median nerve excursion will be assessed by ultrasonography during three positions: standard MNT1, neck flexion with MNT1, and ipsilateral rotation combined with MNT1. Both arms will be tested.

Arm will be held in abduction to 90° - 110° and external rotation to 90°, forearm supination, elbow extension and wrist and fingers extension using a custom made splint.

The standard MNT1 includes neck contralateral side flexion. Then, the researcher will move the neck passively into rotation and flexion. Passive range limit will be determined prior to testing using a goniometer and passive end feel. Movement order will be randomized using an excel random function.

Every position will be tested three times. A single researcher will do all movements passively. Nerve excursion will be measured in real time by the same ultrasonographer who is blinded to patients grouping.

Enrollment: 18 patients

Sex: All

Ages: 30 to 50 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

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

Exclusion criteria

• 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.

Trial design

18 participants in 2 patient groups

Carpal tunnel syndrome

Description:

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.

Treatment:

Procedure: MNT1

Healthy control

Description:

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

Treatment:

Procedure: MNT1