Effectiveness of Neurodinamic Techniques on Radial Nerve for the Treatment of Lateral Epicondylalgia
NCT Number: NCT06468514
Acronym: TT-ST-RN-LE
Status: NOT_YET_RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Lateral Epicondylitis \(Tennis Elbow\)
Interventions: OTHER: neural tensioning technique on radial nerve|OTHER: Sliding technique on radial nerve
Sponsor: University of Alcala
Sex: ALL
Age: ADULT
Enrollment: 64
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: NONE|Primary Purpose: TREATMENT
Start Date: 2024-08-24
Completion Date: 2026-04-15
Locations: Campus Científico Tecnológico. Av. de León. 3A, Alcalá de Henares, Madrid, 28805, Spain

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.

Primary Outcome Measures: Grip strength, his is a continuous quantitative variable. The measurement of grip strength is performed with the subject in a chair with backrest and armrests, his shoulder is in neutral position, and in adduction; the elbow in 90º flexion and the wrist in 30º extension. Participants are asked to perform maximal grip strength with the dynamometer in a self-selected grip position for 6 seconds. According to the American Society of Hand Therapists Guide, a Jamar® hydraulic dynamometer (Lafayette Instrument Company, USA) is used. The measurements were repeated 3 times, with an interval of 1 minute and the mean of the 3 measurements was used for statistical analysis., 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 Outcome Measures: Pain on pressure, This is a continuous quantitative variable. The pain threshold to pressure at the lateral epicondyle was measured with an algometer. The subject remains seated with the arm in 30° of abduction; the elbow in 90° of flexion; and with the forearm, wrist and hand resting on a table. The investigating physical therapist lightly palpates the common extensor tendon to identify the most tender area. Then, starting on the unaffected side, the head of the algometer (hard rubber tip, 1 cm2 surface area) is placed perpendicular to the common extensor tendon at the lateral epicondyle until the patient indicates the moment when the pressure sensation changes to pain. Three measurements are taken on both sides, with a 20-second rest interval between each measurement. The intraobserver reliability of these 3 measurements was excellent (ICC range, .91-.96). For the analysis, the mean value (in kg/cm2 ) of the 3 stresses was calculated. The maximum applied pressure was 6 kg/cm2 ., 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.|global pain, This is a discrete quantitative variable. Pain was measured using the Numerical Pain Rating Scale (NRS-P). The procedure is as follows, the patient is asked at the present moment what pain he/she feels from 0 to 10 if zero is zero pain and 10 is the maximum pain he/she has perceived. The NRS-P is a 10 cm long line calibrated from 0 to 10. 10. The NRS has been shown to have a test-retest reliability of 0.64 to 0.86, from good to excellent (7)., 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.|DASH QUESTIONARY, It is a discrete quantitative variable. The DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire is a self-administered outcome questionnaire that measures physical disability and symptoms of all upper extremity disorders. It includes 30 items related to 120 symptoms and activities of daily living. The total score is 100, and a higher score indicates a greater degree of disability., 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.