Neural Mobilization to Improve Chronic Musculoskeletal Pain in Older Adults

April 1, 2026 updated by: Frederico Mesquita Baptista, Aveiro University

Neural Mobilization in the Treatment of Chronic Musculoskeletal Pain in Older Adults: A Single-Case Experimental Design Study.

The goal of this clinical trial is to discover whether performing active neural mobilization exercises works to manage chronic musculoskeletal pain in older adults. The main question it aims to answer is:

Can an active neural mobilization program improve pain intensity and functional capacity?

Participants will:

  • Perform active neural mobilization exercises for 8 weeks (twice a week), under the in-person supervision of a physiotherapist;
  • Visit the clinic twice a week for 9 to 12 weeks for consultations, examinations, and symptom monitoring;
  • Keep a diary of their symptoms and frequency of analgesic use.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Active, not recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
4

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Portugal
      • Aveiro, Portugal, 3810-193
        • Department of Medical Sciences, University of Aveiro (Portugal)

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Community-dwelling older adults aged 60 years or older
  • People with chronic musculoskeletal pain

Exclusion Criteria:

  • Individuals undergoing surgery in the last 3 months
  • Individuals diagnosed with dementia, cancer, thrombosis, or central nervous system injury (e.g., stroke);
  • Individuals who are receiving another physiotherapy intervention
  • Individuals who do not understand the Portuguese language
  • Individuals with mild cognitive impairment

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Active Neural Mobilization Exercises
Other: Active Neural Mobilization Exercises
Participants will actively perform neural mobilization exercises for the upper and lower limbs, as well as spinal structures.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Pain diary
Time Frame: Every day (until the end of the study) - from week 1 to week 21

Participants will be asked to complete a daily "pain diary," recording:

  • Average pain intensity that day (numerical scale from 0 to 10, where 0 represents "no pain" and 10 represents "the worst pain imaginable");
  • Pain-related interference that day (numerical scale from 0 to 10, where 0 represents "no interference" and 10 represents "maximum interference");
  • Medication used for pain.
Every day (until the end of the study) - from week 1 to week 21

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Pain distribution
Time Frame: Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
A body chart to record the location and distribution of pain.
Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Neuropathic pain components
Time Frame: Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
painDETECT questionnaire - The instrument consists of 4 sections related to: (1) pain intensity in the last 4 weeks; (2) the pain pattern; (3) regions of pain; and (4) presence of neuropathic descriptors. The total score is obtained by adding the scores of the last 3 sections and can vary from 1 to 38. Scores ≤ 12 = the neuropathic mechanism is very unlikely to be present (predominance of the nociceptive mechanism); Scores ≥ 19 = there is a high probability of a predominant neuropathic mechanism; Scores > 12 and < 19 = the presence of a mixed component.
Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Pain Catastrophizing
Time Frame: Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Pain Catastrophizing Scale (PCS) - The instrument has 13 items subdivided into three different subscales: helplessness (items 1, 2, 3, 4, 5, and 12); magnification (items 6, 7, and 13); and rumination (items 8, 9, 10, and 11). All subscales are evaluated on a 5-point Likert scale, from 0 (not at all) to 4 (all the time), where higher scores represent a greater level of catastrophizing.
Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Kinesiophobia
Time Frame: Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Tampa Scale for Kinesiophobia - The instrument comprises 13 items rated on a 4-point Likert scale, as follows: (1) strongly disagree; (2) somewhat disagree; (3) somewhat agree; (4) strongly agree. The higher the score, the greater the fear perceived during the execution of the movement.
Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Signs and symptoms of hypersensitivity of the nervous system
Time Frame: Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Central Sensitization Inventory (CSI) - It assesses common symptoms and facilitating factors for hypersensitivity of the nervous system in 25 items. The patient scores each response on a scale from 0 (never) to 4 (always). The final score is obtained by summing the scores of the individual items and can range from 0 to 100, where higher scores mean a worse outcome.
Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Balance
Time Frame: Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Functional Reach Test
Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Lower Limb Strength
Time Frame: Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Five Times Sit to Stand Test
Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Grip Strength
Time Frame: Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Hand-held dynamometer
Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21)
Range of motion of wrist extension and tibiotarsal movements
Time Frame: Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12.
Measured with a manual goniometer
Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12.
Excursion of the median and fibular nerves
Time Frame: Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12.
Measured by ultrasound
Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12.
Pressure Pain Threshold measured in three different sites (thenar region of the hand; dorsum of foot; region of greatest pain)
Time Frame: Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12.
Measured with an algometer
Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12.
Q-sense - Cold and Warm Perception Threshold (thenar region of the hand; dorsum of foot; region of greatest pain)
Time Frame: Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12.
It will be assessed using a portable quantitative sensory testing device capable of assessing peripheral sensory nerve function using hot and cold thermal sensory thresholds (Q-sense, Medoc).
Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12.
Q-sense - Heat Pain Threshold (thenar region of the hand; dorsum of foot; region of greatest pain)
Time Frame: Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12.
It will be assessed using a portable quantitative sensory testing device capable of assessing peripheral sensory nerve function (Q-sense, Medoc).
Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Aveiro University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 10, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 1, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 27, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 27, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 4, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 3, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 1, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
April 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • SCED1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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