Neural Mobilization to Improve Chronic Musculoskeletal Pain in Older Adults

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: Active, not recruiting
• Conditions: Chronic Musculoskeletal Pain
• Intervention / Treatment: Other: Active Neural Mobilization Exercises

• Study Type: Interventional
• Enrollment (Estimated): 4
• Phase: Not Applicable

Contacts and Locations

Study Locations

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

Participation Criteria

Eligibility Criteria

• 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

How is the study designed?

Design Details

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

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
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

Outcome Measure	Measure Description	Time Frame
Pain diary	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

Outcome Measure	Measure Description	Time Frame
Pain distribution	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	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	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	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	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	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	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	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	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	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)	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)	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)	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

• Sponsor: Aveiro University

Study record dates

Study Major Dates

• Study Start (Actual): March 10, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 1, 2026

Study Registration Dates

• First Submitted: February 27, 2026
• First Submitted That Met QC Criteria: February 27, 2026
• First Posted (Actual): March 4, 2026

Study Record Updates

• Last Update Posted (Actual): April 3, 2026
• Last Update Submitted That Met QC Criteria: April 1, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: older adults; chronic musculoskeletal pain; physical therapy; neural mobilization
• Other Study ID 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