Effects Of Scapulothoracic Intervention With Or Without Neural Mobilization In Patients With Cervico-Brachialgia

Официальное название

Effects Of Scapulothoracic Intervention With Or Without Neural Mobilization On Pain, Function, And Neural Mechano-Sensitivity In Patients With Cervico Brachialgia

Обзор

Cervicobrachialgia is a common musculoskeletal condition characterized by neck pain radiating into the upper limb due to neural and musculoskeletal dysfunctions. It is often associated with pain, functional disability, and increased neural mechanosensitivity, significantly affecting daily activities and quality of life. Various physiotherapy interventions have been used to manage this condition, including neural mobilization and scapulothoracic rehabilitation. However, evidence regarding the combined effectiveness of these interventions remains limited.

Подробное описание

The aim of the study is to determine the effects of scapulothoracic intervention with or without neural mobilization on pain, function, and neural mechanosensitivity in patients with cervicobrachialgia.

Methods: A randomized controlled trial will be conducted on 40 patients diagnosed with cervicobrachialgia. Participants will be randomly allocated into two groups, with 20 participants in each group. Group A received scapulothoracic rehabilitation combined with neural mobilization (ST+NM), while Group B received neural mobilization alone (NM). Treatment will be administered according to the study protocol over the intervention period. Outcome measures includes the Numeric Pain Rating Scale (NPRS) for pain intensity, Neck Pain Questionnaire (NPQ) for neck-related disability, PainDETECT Questionnaire (PDQ) for neuropathic pain symptoms, and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire for upper limb function. Assessments were performed before and after the intervention. Data will be analyzed using paired sample t-tests, independent sample t-tests, Mann-Whitney U tests, and Wilcoxon Signed Rank tests with a significance level of p\<0.05.

Вмешательства

• Другое Scapulothoracic intervention with Neural Mobilization
  Neural Mobilization: Pain-free tension 1. Scapular Mobilization: * Grades III-IV joint mobs (elevation/depression/retraction) * 3 sets × 10 reps 2. Strengthening: * Serratus punches (progress to resistance bands) * Lower trap raises (prone Y-lifts) * 3 sets × 12 reps 3. Neural Mobilization: * ULNT1 sliding technique (6 sec hold/6 sec rest)
• Другое Neural Mobilization
  Neural Mobilization: Pain-free tension 1. Cervical Isometrics: * 4-way neck contractions (5-sec hold) * 3 sets × 10 reps 2. Postural Education: • Ergonomics training 3. Modalities: • TENS (80Hz, 100μs) or moist heat pack 4. Neural Mobilization: * ULNT1 (same as Group A)

Первичные конечные точки

• Visual Analogue Scale (VAS) [Срок оценки: upto 6 weeks]
• Northwick Park Neck Pain Questionnaire (NPQ) [Срок оценки: upto 6 weeks]

Вторичные конечные точки (3)

• PainDETECT questionnaire (PD-Q) [Срок оценки: upto 6 weeks]
• Disability of Arm, Shoulder and Hand (DASH) [Срок оценки: upto 6 weeks]
• FABF Questionnaire (FABQ) [Срок оценки: upto 6 weeks]

Критерии участия

Критерии включения

• Cervicobrachial pain
• Females and males
• Aged 30-50 years
• Able to communicate and follow the instructions
• Able to perform cervical exercises according to cervicogenic pain

Критерии исключения

• Negative neurodynamic test
• Neck and upper extremity surgery
• Vertebral instability
• Vertebral spine infection
• Neurological disease of genetic, infection, or neuroplastic origin
• Inflammatory or systemic disease
• VBI symptoms
• Rheumatoid arthritis
• Subjects with presence of any fractures.
• Heart/diabetic patient

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Список центров уточняется — проверьте первичный протокол.

Публикации

• Wagner FM. [Somatic dysfunction of the cervical spine and its complex clinical picture : The fundamentals of diagnostics of cervicobrachialgia and cervicocephalic syndrome through manual medicine]. Orthopade. 2022 Apr;51(4):263-273. doi: 10.1007/s00132-022-04228-7. Epub 2022 Mar 3. German. PMID 35238967
• Sanchez AC, Requena JBS, Pantaleaon LAL, Esqueda ATI, Raidi VMV, Gallardo IR, et al. # 36401 Post-traumatic compressive C6 cervicobrachialgia, not all that glitters is gold. BMJ Publishing Group Ltd; 2023.
• Kerimova EK, Isaikin AI, Romanova AS, Bashlachev MG, Mouki K. Cervicalgia and cervicobrachialgia in periarticular cyst at the cervical level. Case report. Consilium Medicum. 2025;27(02):94-8.
• Thomson S, Ainsworth G, Selvanathan S, Brown S, Croft J, Kelly R, Mujica-Mota R, Rousseau N, Higham R, Stocken D. Clinical and cost-effectiveness of PCF versus ACD in the treatment of cervical brachialgia (FORVAD trial). Br J Neurosurg. 2024 Feb;38(1):141-148. doi: 10.1080/02688697.2023.2267119. Epub 2024 Jan 27. PMID 37807634
• Fujastawan IGV. Management of Physiotherapy in Case of Brachialgia Due to Cervical Spondyloarthrosis. Science Midwifery. 2022;10(2):755-8.
• Rani A, Chopra J, Singh RR, Bajpai PK. Prevalence of various anomalies of costal element at cervico-thoracic junction in and around lucknow region of uttarpradesh: A radiological study. Biomed Res. 2021;32(1):7-14.
• AHMED AA, SHABAN M. Conservative Treatment of Cervical Discs without Myelopathy: A Three Years Follow-up. The Medical Journal of Cairo University. 2023;91(03):403-7.
• Thomson S, Ainsworth G, Selvanathan S, Kelly R, Collier H, Mujica-Mota R, Talbot R, Brown ST, Croft J, Rousseau N, Higham R, Al-Tamimi Y, Buxton N, Carleton-Bland N, Gledhill M, Halstead V, Hutchinson P, Meacock J, Mukerji N, Pal D, Vargas-Palacios A, Prasad A, Wilby M, Stocken D. Posterior cervical foraminotomy versus anterior cervical discectomy for Cervical Brachialgia: the FORVAD RCT. Health T PMID 37929307

Идентификаторы

NCT: NCT07724665 · REC/RCR & AHS/25/0141

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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