Clinical trial NCT06468514: Effectiveness of Neurodinamic Techniques on Radial Nerve for the Treatment of Lateral Epicondylalgia
Official title: Effectiveness of 'Tensioning Techniques' vs 'Sliding Techniques' on Radial Nerve for the Treatment of Lateral Epicondylalgia
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Lateral Epicondylitis \(Tennis Elbow\)
Keywords: Epicondylalgia Neural mobilization Neural tension Physiotherapy Radial nerve
Lead sponsor: University of Alcala
Sponsor class: OTHER
First posted: 2024-06-21
Enrollment: 64
Sex: ALL
Minimum age (years): 30
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Lateral elbow pain is a prevalent musculoskeletal disorder in the working population due to overuse of the upper limb. This pathology has serious consequences for health, work performance and overall health burden.

In this injury, as in any musculoskeletal disorder, the peripheral nervous system is involved. Because of its course and corresponding motor and sensory innervation in the area, the radial nerve should be taken into consideration as a structure involved in elbow pain.

The aim of the present study is to demonstrate which of the neurodynamic techniques is more effective in lateral epicondylalgia, neural tension techniques or neural mobilization techniques.

Detailed description: The aim of the present study is to demonstrate which is more effective among the neurodynamic techniques for lateral epicondylalgia, neural tension techniques or neural mobilization techniques.

A total of 60 subjects will be recruited and divided into 2 groups. 30 in Group 1 where they will receive a neural mobilization technique on the radial nerve and 30 in Group 2 where they will be subjected to a neural tension technique on the radial nerve.

The data to be collected will be grip strength, pain on pressure, pain and quality of life dash questionnaire, these data will be measured pre, post treatment and a re-evaluation at 4 weeks and 24 weeks after the intervention.

The duration of the treatment is 6 weeks, performing two sessions per week with 72 hours of rest between sessions. A total of 12 sessions will be carried out.

Eligibility criteria: Inclusion Criteria:

* Patient diagnosed with lateral epicondylalgia.
* Experiencing elbow pain of 2 to 6 months duration.
* Age between 30 and 60 years old.
* Radial humeral joint tenderness to palpation.
* Positive Cozen\&#39;s test

Exclusion Criteria:

* - Bilateral symptoms.
* Rheumatologic disease involving the elbow and wrist
* Musculoskeletal disorder due to connective tissue pathology
* Cervical radiculopathy
* Nerve compression including the upper extremity
* Operation on the affected arm
* Having received treatment for epicondylalgia in the last 6 months
* Radiating pain from the cervical spine
* Instability of the external ligamentous complex of the elbow(3).
* Not having received any physiotherapy session in the month prior to the start of the study.
* Neural clinical manifestations (electric shock-like pain, tingling, tingling, numbness and/or burning).

Primary outcomes:
measure: Grip strength
timeFrame: the duration of the program will be 6 weeks, with two sessions per week with 72 hours of rest between sessions. A total of 12 sessions will be carried out. A re-evaluation will be done 4 weeks after the final evaluation and another one after 24 weeks.
Secondary outcomes:
measure: Pain on pressure
timeFrame: the duration of the program will be 6 weeks, with two sessions per week with 72 hours of rest between sessions. A total of 12 sessions will be carried out. A re-evaluation will be done 4 weeks after the final evaluation and another one after 24 weeks.
measure: global pain
timeFrame: the duration of the program will be 6 weeks, with two sessions per week with 72 hours of rest between sessions. A total of 12 sessions will be carried out. A re-evaluation will be done 4 weeks after the final evaluation and another one after 24 weeks.
measure: DASH QUESTIONARY
timeFrame: the duration of the program will be 6 weeks, with two sessions per week with 72 hours of rest between sessions. A total of 12 sessions will be carried out. A re-evaluation will be done 4 weeks after the final evaluation and another one after 24 weeks.
Other outcomes:
Locations:
city: Alcalá de Henares
country: Spain
facility: Campus Científico Tecnológico. Av. de León. 3A
state: Madrid
Study officials:
affiliation: University of Alcalá
name: María Balsa-Amarante, MSc
role: PRINCIPAL_INVESTIGATOR
References:
citation: Gamelas T, Fernandes A, Magalhaes I, Ferreira M, Machado S, Silva AG. Neural gliding versus neural tensioning: Effects on heat and cold thresholds, pain thresholds and hand grip strength in asymptomatic individuals. J Bodyw Mov Ther. 2019 Oct;23(4):799-804. doi: 10.1016/j.jbmt.2019.04.011. Epub 2019 Apr 24.
citation: Ellis R, Carta G, Andrade RJ, Coppieters MW. Neurodynamics: is tension contentious? J Man Manip Ther. 2022 Feb;30(1):3-12. doi: 10.1080/10669817.2021.2001736. Epub 2021 Nov 16.
citation: Yilmaz K, Yigiter Bayramlar K, Ayhan C, Tufekci O. Investigating the effects of neuromobilization in lateral epicondylitis. J Hand Ther. 2022 Jan-Mar;35(1):97-106. doi: 10.1016/j.jht.2020.11.003. Epub 2020 Nov 13.
citation: Arumugam V, Selvam S, MacDermid JC. Radial nerve mobilization reduces lateral elbow pain and provides short-term relief in computer users. Open Orthop J. 2014 Oct 17;8:368-71. doi: 10.2174/1874325001408010368. eCollection 2014.
citation: Taylor A, Wolff AL. The forgotten radial nerve: A conceptual framework for treatment of lateral elbow pain. J Hand Ther. 2021 Apr-Jun;34(2):323-329. doi: 10.1016/j.jht.2021.05.009. Epub 2021 Jun 27.