Effect of Chitosan Phonophoresis On Cubital Tunnel Syndrome
Condition: Cubital Tunnel Syndrome; Ulnar Nerve Entrapment at Elbow; Ulnar Nerve Compression; Ulnar Nerve Entrapment Syndrome
MeSH terms: Nerve Compression Syndromes; Cubital Tunnel Syndrome; Charcot-Marie-Tooth Disease; Hereditary Sensory and Motor Neuropathy; Ulnar Nerve Compression Syndromes; Syndrome
Study type: Interventional

Summary: 
      - This study will be conducted to answer the following question: Is there a statistically
      significant effect of chitosan phonophoresis on ulnar nerve conduction velocity, pain level &
      function in patients with mild to moderate cubital tunnel syndrome?

      - Fifty-four subjects suffering from mild to moderate cubital tunnel syndrome according to
      modified McGowan grading system (Palmer & Hughes, 2010) from both sexes diagnosed clinically
      by electromyography will be recruited for this study. The Age of the participants will range
      from 20 - 40 years old. Participants with Body mass index between 18.5 and 24.9kg/m2.

      EMS physio Ltd ultrasound device will be used in combination with chitosan nanoparticles gel.

      Electrodiagnostic test will be performed for ulnar nerve conduction velocity using Neuropack
      S1 MEB-9004 NIHON KODEN, JAPAN. Visual analogue scale (VAS) will be used to determine pain
      level. Quick DASH will be used to determine hand function.Patients will have 3 sessions per
      week for 5 weeks.
    


Intervention name(s): Chitosan Phonophoresis; Therapeutic Ultrasound; Splinting; Neural mobilization exercises of the ulnar nerve
Intervention type(s): Device; Device; Device; Other
Intervention description(s): Therapeutic pulsed ultrasound using EMS physio Ltd ultrasound device in presence of chitosan gel will be applied over the elbow. The following parameters will be used: US treatment was applied for 5 min per session at a frequency of 3 MHz and an intensity of 0.5 W/cm2 in pulsed mode with a transducer area of 5 cm2.; US treatment will be applied for 5 min per session at a frequency of 3 MHz and an intensity of 0.5 W/cm2 in pulsed mode with a transducer area of 5 cm2 using aquasonic gel.; Splinting the elbow in comfortable flexion (40-70), forearm and wrist in neutral (slight forearm pronation and wrist flexion if symptoms are severe), can allow the nerve and surrounding supporting structures the rest and relief from compression and traction.
The elbow portion of the splint should be well padded or ''bubbled out'' to provide pressure relief for the area of the cubital tunnel. It may be necessary to splint the ulnar digits of the hand to prevent contracture, maintain passive and active range of motion, and improve hand function. If the motor branch of the nerve is sufficiently involved to cause muscle denervation, a hand-based intrinsic plus splint or the use of finger-based splints to prevent clawing of the ring and small fingers will provide balanced positioning of the affected structures.; Nerve mobilization exercises Inflammation or adhesions anywhere along the ulnar nerve path can cause the nerve to have limited mobility and essentially get stuck in one place. These exercises help stretch the ulnar nerve and encourage movement through the cubital tunnel
Intervention MeSH terms: Chitosan
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Care Provider, Outcomes Assessor)
Primary purpose: Treatment