Effectiveness of Scapula Mobilization on Mechanosensitivity of Upper Limb Neural Test 1 in Mechanical Neck Pain
Condition: Neck Pain; Musculoskeletal Diseases
MeSH terms: Musculoskeletal Diseases; Neck Pain
Study type: Interventional

Summary: 
      Between 45% and 70% of the general population suffers neck pain at some point in their lives,
      making it one of the most frequent reasons for taking sick leave. Given its importance in
      physiotherapy at clinical level, we seek to observe how a scapular mobilization technique
      might influence the neural mechanosensitivity of the median nerve as measured by Upper Limb
      Neural Test 1 (ULNT1) on subjects with neck pain.

      Hypotheses and objectives. Performing a scapular mobilization technique on subjects with neck
      pain and a positive ULNT1 improves the patient's response to said test. It also decreases the
      patient's neck pain as measured using a Visual Analog Scale (VAS) for pain and increases grip
      strength.

      Material and method. A single-blind clinical trial was performed on subjects randomly
      assigned to either a treatment group or control group. The sample consisted of 60 subjects (N
      = 60) -30 in the treatment group (n = 30) and the other 30 as a control (n = 30) -and was
      made up of patients with neck pain and a positive ULNT1. A scapular mobilization was
      performed on the first group and on the second, a calcaneus abduction adduction on the
      opposite side from the positive ULNT1 as a placebo.
    

Detailed description: 
      Mechanical cervicalgia is a very frequent and important clinical picture in physiotherapy
      consultations. It can be considered as a pluripatology as it covers somatic, functional,
      psychological and social aspects. This ailment is suffered by between 45 and 70% of the
      general population during some period of life and is one of the most frequent justifications
      of work leave and the main cause of permanent disability. Mechanical cervicalgia
      significantly decreases the quality of life of those who suffer from it: it frequently
      produces a significant disability when generating pain, functional deficit, headaches,
      movement restriction, vertiginous syndromes, nausea and / or vomiting, etc. This leads to
      reduced work time and increased health system costs, causing a strong economic and social
      impact. For example, Borghouts JA and Cols point out that in the Netherlands in 1996 these
      costs were approximately 686 million dollars, which constituted 1% of total health
      expenditure and 0.1% of its Gross Domestic Product (GDP) . In Spain, referrals to the
      cervicalgia physiotherapy service represent 10% of the total of all health demands; in
      Britain this percentage reaches 15% and in Canada 30%. Likewise, it should be considered that
      the direct cost caused by cervicalgia to the health system in our country, specifically to
      the Primary Care consultation, constitutes 2% of the total, and in some centers this figure
      reaches up to 12% if they are considered diagnostic tests, pharmaceutical expenses and visits
      to the specialist.
    

Intervention name(s): Interscapular muscle release or scapular mobilization technique as described by Travell and Simons.; Calcaneus abduction and adduction mobilization technique
Intervention type(s): Other; Other
Intervention description(s): Patient is sidelying with the testing side up. The auditor stands in front of the patient, reaches over the patient's shoulder to grasp the upper portion of the vertebral border of the scapula, and the other arm reaches under the patient's humerus to grasp the lower portion of the vertebral border of the scapula.
The auditor then slowly moves the scapula into elevation/depression, internal/external rotation/abduction and adduction.
To standardize the technique and be able to reproduce it in each participant, a set of 10 repetitions for each movement was performed in the same order.; Abduction and adduction mobilization of the calcaneus is carried out in the opposite side of the upper extremity measured.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized prospective controlled trial
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Median Nerve; Hand Strength; Brachial plexus; Physical Therapy Modalities; Neck Pain