Does Cervical Mobilization Have an Effect on Hand Function in Patients With Double Crush Syndrome?

All Double Crush Syndrome patients were assessed via VAS, BCTQ & Nerve conduction study before and after the treatment program.

Study Overview

• Status: Completed
• Conditions: Double Crush Syndrome
• Intervention / Treatment: Other: Traditional physical therapy treatment; Other: Cervical Mobilization

Detailed Description

The patients were classified randomly into two groups, the control group received a standard physical therapy program of nerve glide, hand strengthening exercise and mobilization and the study group they received a cervical mobilization in addition to the standard physical therapy program for 12 sessions.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Menoufia
    • Sadat, Menoufia, Egypt
      • Al Ryada University for Science and Technology

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Thirty female patients diagnosed as Double Crush Syndrome based on the clinical diagnostic criteria of the American Academy of Neurology, (American Academy of Neurology 2019).
• Patient ages ranged from 25 to 35 years old. Patient who reported pain, hyperesthesia, and/or paresthesia at the course of median nerve distribution and upper limb.
• A Nerve Conduction Study (NCS) evidence of peripheral entrapment of median nerve at level of carpal bone "Carpal tunnel Syndrome" with a fractionated sensory nerve conduction velocity for the median nerve across the wrist of 40 m/s or less and with sensory peak latency > 3.6 ms and recordable and with motor distal latency >4.4 ms and less than 6.5ms.

Exclusion Criteria:

• Patients had Systemic disease causes double Crush Syndrome as rheumatoid arthritis (RA), thyroid disease, Diabetes mellitus (DM), Pregnant women, Patients with concomitant neurological disease as peripheral neuropathy, Patients with history of wrist surgery, fracture, or carpal tunnel injection in the last two weeks before the study, Patients who have wasting of the thenar muscles, Patients with previous surgery for CTS.
• Patients with complete conduction block on EDX or previous regular exposure to hand-held vibrating tools, Patients with Nerve Conduction Study with motor distal latency > 6.5 ms.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Control Group; received a standard physical therapy program of nerve glide, hand strengthening exercise and mobilization	Other: Traditional physical therapy treatment; tendon gliding exercises, median nerve gliding exercise, strengthening exercises for 60 minutes
Experimental: Study Group; received a cervical mobilization in addition to the standard physical therapy program for 12 sessions	Other: Traditional physical therapy treatment; tendon gliding exercises, median nerve gliding exercise, strengthening exercises for 60 minutes; Other: Cervical Mobilization; The technique is used to mobilize a specific cervical or upper thoracic segment (C2-C3 through T3-T4) in a posterior to anterior direction. The therapist gently applies pressure in an anteroposterior direction in the plane of the facet joint to assess mobility, resistance, end feel, and pain provocation. Gentle oscillations can be used to either inhibit pain (grades I and II) or restore motion (grades III and IV). Slight variations in depth and direction of force can be used to optimize the therapeutic effects of this technique.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nerve conduction study	Used to assess sensory and motor fibers of median nerve to determine the improvement in nerve capacity and hand function	4 weeks
Visual analogue scale	Used to assess degree of pain	4 weeks
Boston carpal tunnel syndrome questionnaire	Used to assess patients' functional ability and symptoms severity	4 weeks

Collaborators and Investigators

• Sponsor: Ahmed Alshimy

Study record dates

Study Major Dates

• Study Start (Actual): August 2, 2022
• Primary Completion (Actual): August 5, 2023
• Study Completion (Actual): January 8, 2024

Study Registration Dates

• First Submitted: July 2, 2024
• First Submitted That Met QC Criteria: July 2, 2024
• First Posted (Actual): July 10, 2024

Study Record Updates

• Last Update Posted (Actual): July 12, 2024
• Last Update Submitted That Met QC Criteria: July 11, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: hand function; cervical mobilization; double crush syndrome
• Additional Relevant MeSH Terms: Pathologic Processes; Wounds and Injuries; Disease; Crush Injuries; Shock, Traumatic; Syndrome; Crush Syndrome
• Other Study ID Numbers: P.T.REC/012/003943

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