Clinical trial NCT03970408: Median Nerve Excursion During Neurodynamic Mobilization
Official title: Effect of Neck Movements on Median Nerve Longitudinal Excursion During Neurodynamic Mobilization in Patients With Carpal Tunnel Syndrome
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: CTS
Keywords: Median nerve,
Carpal tunnel syndrome
Neurodynamic mobilization
Lead sponsor: Cairo University
Sponsor class: OTHER
First posted: 2019-05-31
Enrollment: 18
Sex: ALL
Minimum age (years): 30
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients will be selected from primary care clinics.

Brief summary: 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.

Detailed 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.

Eligibility criteria: 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.

Primary outcomes:
measure: Changes in longitudinal median nerve excursion with neck flexion
timeFrame: One day
measure: Changes in longitudinal median nerve excursion with ipsilateral neck rotation
timeFrame: One day
Secondary outcomes:
Other outcomes:
Locations:
city: Cairo
country: Egypt
facility: Ain Shamas University
city: Cairo
country: Egypt
facility: Cairo University Hospital
Study officials:
affiliation: Cairo University
name: Aliaa Rehan Youssef, Phd
role: PRINCIPAL_INVESTIGATOR
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