Effects of Neuromobilization on Median Nerve Elasticity

Purpose: The aim of this study was to investigate the effect of median nerve neuromobilization on median nerve elasticity using shear wave elastography.

Methods: The study included 36 healthy volunteers (72 upper extremities) aged 18-30 years. Inclusion criteria; no known systemic neuromuscular and metabolic diseases, no nerve impingement syndrome, and no upper extremity bone-tendon-muscle surgery in the last six months. Sociodemographic data of the participants were recorded. Wrist flexion and extension bilaterally with universal goniometer and finger grip strength bilaterally were measured with pinchmeter. Median Nerve Stress Test was performed. Median nerve elasticity was measured by Shear Wave Ultrasound Elastography. The extremity of the dominant side as a study group and the non-dominant side as a control group were measured bilaterally. Median nerve neuromobilization (stretching (n = 18) and shifting (n = 18)) was applied to the upper extremities of the dominant side. The application was carried out as 3 sets in one session. Evaluations were repeated after application.

Study Overview

• Status: Completed
• Conditions: Median Nerve Disease
• Intervention / Treatment: Other: neuromobilization exercises

• Study Type: Interventional
• Enrollment (Actual): 18
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey, 34010
    • Istinye University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 30 years (ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 18-30 years of age
• Healthy individuals without any known systemic disease

Exclusion Criteria:

• Those who have undergone an upper extremity bone-tendon-muscle operation in the last six months
• People with a systemic disease such as rheumatoid arthritis, diabetes mellitus
• Patients with any neuromuscular disease

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: neuromobilization stretching group; In the neuromobilization stretching group; The subjects were brought to shoulder depression and 90 degrees of abduction while the dominant side forearms were supination. In this position, median nerve stretching was performed by extending the participant's head to the opposite side while flexing the wrist and finger. After waiting for 30 seconds in this position, the wrist and head were moved to the neutral position and the participants relaxed.	Other: neuromobilization exercises; Median nerve neuromobilization (stretching and shifting) was performed. For median nerve stretching; The subjects were brought to shoulder depression and 90 degrees of abduction while the dominant side forearms were supination. In this position, median nerve stretching was performed by extending the participant's head to the opposite side while flexing the wrist and finger. After waiting for 30 seconds in this position, the wrist and head were moved to the neutral position and the participants relaxed. For median nerve shift; The subjects were brought to shoulder depression and 90 degrees of abduction while the dominant side forearms were supination. In this position, the participant flexed his wrist and fingers while lateral flexion of his head to the opposite side, and flexed his wrist and fingers while lateral flexion of the head to the same side.
EXPERIMENTAL: neuromobilization shifting group; In the neuromobilization shifting group, the subjects were brought to shoulder depression and 90 degrees of abduction while the dominant forearms were supination. In this position, the participant flexed his wrist and fingers while lateral flexion of his head to the opposite side, and flexed his wrist and fingers while lateral flexion of the head to the same side. Thus, the participants performed median nerve shift.	Other: neuromobilization exercises; Median nerve neuromobilization (stretching and shifting) was performed. For median nerve stretching; The subjects were brought to shoulder depression and 90 degrees of abduction while the dominant side forearms were supination. In this position, median nerve stretching was performed by extending the participant's head to the opposite side while flexing the wrist and finger. After waiting for 30 seconds in this position, the wrist and head were moved to the neutral position and the participants relaxed. For median nerve shift; The subjects were brought to shoulder depression and 90 degrees of abduction while the dominant side forearms were supination. In this position, the participant flexed his wrist and fingers while lateral flexion of his head to the opposite side, and flexed his wrist and fingers while lateral flexion of the head to the same side.
NO_INTERVENTION: Control Group; The dominant sides of the individuals are experimental sides and the other nondominant sides of the participants are control sides. And no intervention was made. All measurements were done bilaterally before and after.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Median Nerve Tension Test	The test was performed in a position with shoulder depression and 90 degrees abduction and external rotation, elbow 90 degrees flexion, forearm full supination, and wrist and fingers fully extended. Maintaining this position, the elbow was passively extended and the tension of the median nerve was tested. The test was stopped at the point where the patient felt pain and tension, and the angle at the elbow was measured by a universal goniometer.	4 weeks
Median nerve elasticity with Shear Wave Ultrasound Elastography	The nerve elasticity was measured by measuring the velocity of shear waves in the median nerve by means of high frequency ultrasound waves.	4 weeks
Bilaterally finger grip strength with pinchmeter	finger grip strength was measured bilaterally by pinch meter.	4 weeks

Collaborators and Investigators

• Sponsor: Istinye University

Study record dates

Study Major Dates

• Study Start (ACTUAL): November 10, 2019
• Primary Completion (ACTUAL): December 15, 2019
• Study Completion (ACTUAL): December 25, 2019

Study Registration Dates

• First Submitted: January 2, 2020
• First Submitted That Met QC Criteria: January 2, 2020
• First Posted (ACTUAL): January 6, 2020

Study Record Updates

• Last Update Posted (ACTUAL): July 30, 2020
• Last Update Submitted That Met QC Criteria: July 28, 2020
• Last Verified: July 1, 2020

More Information

Terms related to this study

• Keywords: shear wave elastography; neuromobilization; elasticity
• Additional Relevant MeSH Terms: Neuromuscular Diseases; Mononeuropathies; Peripheral Nervous System Diseases; Nervous System Diseases; Median Neuropathy
• Other Study ID Numbers: 005

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No