Neural Mobilization in Cervico-Brachial Neuralgia (NM-CBN)

Hopital Charles Nicolle

Status: Completed

Conditions: Cervico Brachialgia

Treatments: Procedure: neural mobilisation; Procedure: conventional rehabilitation

Study type: Interventional

Funder types: Other

Identifiers

NCT06913062

ECR-OMG-2024-303 (Other Identifier)

ECR-OMG-2024-302

Details and patient eligibility

About

This study aimed to compare the effectiveness of neural mobilization (NM) combined with conventional rehabilitation versus conventional rehabilitation alone in patients with chronic common cervico-brachial neuralgia (CBN), focusing on pain, cervical range of motion (ROM), functional disability, and psychological state.

A randomized controlled trial was conducted including patients with chronic CBN. They were randomized into two groups: control group received standard rehabilitation, while NM Group received the same treatment with additional NM techniques. Evaluations were conducted pre- and post-treatment, assessing pain, cervical ROM, functional disability and psychological state via the Beck Depression Inventory.

Enrollment: 32 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients over 18 years old
• with chronic common CBN

Exclusion criteria

• secondary CBN
• prior cervical surgery
• cervical trauma
• recent central or peripheral neurological conditions
• unstable cauda equina lesions,
• untreated tumors or infections.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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32 participants in 2 patient groups

control group

Active Comparator group

Description:

For control group, the conventional rehabilitation protocol aimed to alleviate muscular and neuropathic pain in the short term, improve cervical mobility, reduce muscle tension, and increase muscle strength in the medium term, and promote a healthy lifestyle along with socio-professional reintegration in the long term. The principles included educating patients about their condition, respecting pain thresholds, and considering fatigue levels. Each patient received treatment for two months, with three sessions per week, each lasting about one hour. The protocol consisted of three phases: the first week focused on relaxation through massage and low-frequency electrotherapy; the second week introduced passive joint mobilizations; and from the third week, muscle stretching and strengthening exercises were incorporated. Additionally, functional exercises targeting daily activities and body awareness techniques are included to maintain proper posture.

Treatment:

Procedure: conventional rehabilitation

NM arm

Experimental group

Description:

For NM group, long-term goals included improving neuromeningeal mobility and restoring function to neural structures. Each patient received the treatment for two months, with three sessions per week, each lasting about one hour. After addressing joint limitations and muscle tensions affecting radicular mobility, NM was introduced starting from the fourth week. The protocol was structured around three main axes: treatment of interfaces (joint mobilizations and traction), direct treatment (using neurodynamic techniques), and indirect treatment (neural self-mobilization and lifestyle advice). The treatment included various stages for each ULNT technique \[9\]. ULNT1 targeted the median nerve and involved shoulder abduction, elbow extension, and head inclination. ULNT2 focused on scapular depression and targeted cervical roots. ULNT3 emphasized radial nerve tension with internal rotation of the shoulder, while ULNT4 addressed ulnar nerve tension through elbow flexion and shoulder abduction

Treatment:

Procedure: conventional rehabilitation

Procedure: neural mobilisation