Clinical trial NCT05537636: Physical Therapy on Non-structural Medial Elbow Pain
Official title: Effect of Regional Interdepence Physical Therapy Approach on Non-structural Medial Elbow Pain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Elbow Injuries and Disorders
Neuritis, Ulnar
Neuritis, Brachial
Neuritis; Nerve Root
Neuritis Median Nerve
Keywords: Regional Interdependence
Posture
Neural Tension
Physical Therapy
Lead sponsor: University of Kentucky
Sponsor class: OTHER
Collaborators: name: Bluegrass Orthopedics
First posted: 2022-09-13
Enrollment: 22
Sex: ALL
Minimum age (years): 15
Maximum age (years): 50
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Cohort longitudinal
Primary purpose: TREATMENT

Brief summary: This study is investigating the effect of using a regional interdependence approach of managing non-structural elbow pain with physical therapy.

Detailed description: Potential patients will be referred for physical therapy with elbow nerve pain arising from a non-structural lesion. We believe by addressing spine and trunk posture and mobility we can relieve elbow pain associated with a nerve compression with physical therapy.

Patients will be put on a staged exercise program to regain spinal mobility and strengthen proximal core musculature and scapular musculature. Manual therapy to facilitate mobility will be incorporated. Patients will undergo standard physical therapy by an unblinded therapist until resolution of symptoms.

Eligibility criteria: Inclusion Criteria:

* The patient presents with elbow pain that is not exacerbated with resisted wrist flexion, extension, supination, or pronation.
* The patient presents with elbow pain that is not exacerbated with passive wrist flexion or extension.
* The patient presents with three of the four positive cervical radicular signs
* Patient presents with peripheral paresthesia

Exclusion Criteria:

* The patient reports a surgical history involving the elbow.
* The patient has an MRI that is positive for structural deficits within the upper extremity.
* The patient self-reports a diagnosis of rheumatoid arthritis or other neurological systemic diseases such as Parkinson's disease, cerebrovascular accident, multiple sclerosis, or similar conditions

Primary outcomes:
measure: Change in Cervical Range of Motion in extension
timeFrame: Baseline and every 5th visit up to discharge which is estimated to be 3 months on average
measure: Change in Focus On Therapeutic Outcome (FOTO) Patient Outcme Score
timeFrame: Baseline and every 5th visit up to discharge which is estimated to be 3 months on average
measure: Change in Lower Trapezius scapular muscle strength
timeFrame: Baseline and every 5th visit up to discharge which is estimated to be 3 months on average
Secondary outcomes:
measure: Change in Elbow Flexion Range of Motion in Ulnar Nerve Tension position
timeFrame: Baseline and every 5th visit up to discharge which is estimated to be 3 months on average
measure: Change in Elbow Extension Range of Motion in Median Nerve Tension positoin
timeFrame: Baseline and every 5th visit up to discharge which is estimated to be 3 months on average
Other outcomes:
Locations:
city: Lexington
country: United States
facility: Bluegrass Orthopaedics
state: Kentucky
Study officials:
affiliation: University of Kentucky
name: Tim L Uhl, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Sueki DG, Cleland JA, Wainner RS. A regional interdependence model of musculoskeletal dysfunction: research, mechanisms, and clinical implications. J Man Manip Ther. 2013 May;21(2):90-102. doi: 10.1179/2042618612Y.0000000027.
citation: Wickstrom BM, Oakley PA, Harrison DE. Non-surgical relief of cervical radiculopathy through reduction of forward head posture and restoration of cervical lordosis: a case report. J Phys Ther Sci. 2017 Aug;29(8):1472-1474. doi: 10.1589/jpts.29.1472. Epub 2017 Aug 10.
citation: Day JM, Willoughby J, Pitts DG, McCallum M, Foister R, Uhl TL. Outcomes following the conservative management of patients with non-radicular peripheral neuropathic pain. J Hand Ther. 2014 Jul-Sep;27(3):192-9; quiz 200. doi: 10.1016/j.jht.2014.02.003. Epub 2014 Feb 27.
citation: Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine (Phila Pa 1976). 2003 Jan 1;28(1):52-62. doi: 10.1097/00007632-200301010-00014.
citation: Nee RJ, Jull GA, Vicenzino B, Coppieters MW. The validity of upper-limb neurodynamic tests for detecting peripheral neuropathic pain. J Orthop Sports Phys Ther. 2012 May;42(5):413-24. doi: 10.2519/jospt.2012.3988. Epub 2012 Mar 8.