Neural Mobilization After Upper Extremity Fatigue in Amateur Athletes

Acute Effects of Neural Mobilization After Physical Fatigue on Upper Extremity Performance and Hand-Eye Coordination in Amateur Athletes: A Randomized Controlled Trial

This randomized controlled trial evaluated the acute effects of neural mobilization and dynamic stretching after upper extremity fatigue on upper extremity performance and hand-eye coordination in amateur athletes. Participants were amateur athletes aged 18 to 25 years who regularly participated in sports involving active use of the upper extremity. After baseline assessment, all participants completed a standardized upper extremity fatigue protocol. They were then randomly allocated to one of three groups: neural mobilization, dynamic stretching, or passive rest. Outcomes were assessed at baseline, immediately after fatigue, and after the assigned recovery intervention or rest period. The study aimed to determine whether active recovery strategies, particularly neural mobilization, provide greater short-term recovery of upper extremity performance and hand-eye coordination compared with passive rest.

Study Overview

• Status: Completed
• Conditions: Athletic Performance; Hand-Eye Coordination; Exercise-Induced Upper Extremity Fatigue
• Intervention / Treatment: Other: Neural Mobilization; Other: Dynamic Stretching

• Study Type: Interventional
• Enrollment (Actual): 45
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Antakya
    • Hatay, Antakya, Turkey (Türkiye)
      • Hatay Mustafa Kemal University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Aged between 18 and 25 years
• Amateur athlete participating in a sport requiring active use of the upper extremity, such as basketball, volleyball, tennis, or table tennis
• Able to understand and perform the fatigue protocol, recovery intervention, and outcome assessments
• Volunteered to participate and provided written informed consent

Exclusion Criteria:

• Current upper extremity, cervical, or trunk pain or injury that could affect test performance
• History of upper extremity surgery, fracture, or major musculoskeletal trauma that could limit participation
• Neurological, vestibular, or systemic condition affecting upper extremity function, balance, coordination, or exercise tolerance
• Any cardiovascular, respiratory, or medical condition contraindicating participation in fatiguing upper extremity exercise
• Inability to complete the fatigue protocol or outcome assessments safely

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Neural Mobilization; Participants assigned to this arm received upper extremity neural mobilization after completion of the standardized upper extremity fatigue protocol. Neural mobilization techniques targeted the median, radial, and ulnar nerves and were applied during the recovery period before post-intervention outcome assessment.	Other: Neural Mobilization; Upper extremity neural mobilization was applied after the standardized fatigue protocol. The intervention targeted the median, radial, and ulnar nerves using non-painful mobilization techniques. Each technique was performed for 2 sets of 20 repetitions, with each repetition lasting approximately 1 to 3 seconds
Experimental: Dynamic Stretching; Participants assigned to this arm performed a structured dynamic stretching protocol after completion of the standardized upper extremity fatigue protocol. The protocol included dynamic upper and lower body movements performed during the recovery period before post-intervention outcome assessment.	Other: Dynamic Stretching; A structured dynamic stretching protocol was performed after the standardized fatigue protocol. The protocol lasted approximately 10 minutes and included dynamic upper extremity and whole-body movements such as arm swings, arm crossovers, walking lunges with trunk rotation, lateral shuffling, heel kicks, inchworms, and modified shuttle movements.
No Intervention: Control; Participants assigned to this control arm rested passively after completion of the standardized upper extremity fatigue protocol. No active recovery intervention was administered during the recovery period before post-intervention outcome assessment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Alternate Hand Wall Toss Test	Hand-eye coordination was assessed using the Alternate Hand Wall Toss Test. Participants stood 2 meters from a wall and repeatedly threw a ball against the wall, catching it with the opposite hand. The number of successful catches completed within 30 seconds was recorded. Higher scores indicate better hand-eye coordination performance.	Baseline, immediately after the fatigue protocol, and after the 15-minute recovery period
Upper Quarter Y Balance Test	Upper quarter dynamic balance was assessed using the Upper Quarter Y Balance Test. Participants maintained a push-up position and reached with the free hand in the medial, superolateral, and inferolateral directions. Reach distances were recorded and used to calculate a composite score normalized to upper limb length. Higher scores indicate better upper quarter dynamic balance performance.	Baseline, immediately after the fatigue protocol, and after the 15-minute recovery period

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Closed Kinetic Chain Upper Extremity Stability Test	Upper extremity functional performance was assessed using the Closed Kinetic Chain Upper Extremity Stability Test. Participants performed alternating hand touches across two marked lines while maintaining a push-up position. The number of touches completed within 15 seconds was recorded. Higher scores indicate better upper extremity functional performance.	Baseline, immediately after the fatigue protocol, and after the 15-minute recovery period

Collaborators and Investigators

• Sponsor: Uludag University

Publications and helpful links

General Publications

• Kim MK, Cha HG, Ji SG. The initial effects of an upper extremity neural mobilization technique on muscle fatigue and pressure pain threshold of healthy adults: a randomized control trial. J Phys Ther Sci. 2016 Mar;28(3):743-6. doi: 10.1589/jpts.28.743. Epub 2016 Mar 31.
• Hodgetts CJ, McLeish T, Thomas E, Walker BF. Association Between Chiropractic Students' Hand-Eye Coordination or General Self-efficacy and Their Performance on a Spinal Manipulative Therapy Examination: A Cross-sectional Study. J Chiropr Med. 2021 Dec;20(4):183-190. doi: 10.1016/j.jcm.2021.12.011. Epub 2022 Apr 6.
• Dupuis F, Sole G, Mercier C, Roy JS. Impact of fatigue at the shoulder on the contralateral upper limb kinematics and performance. PLoS One. 2022 Apr 1;17(4):e0266370. doi: 10.1371/journal.pone.0266370. eCollection 2022.

Study record dates

Study Major Dates

• Study Start (Actual): December 19, 2025
• Primary Completion (Actual): May 28, 2026
• Study Completion (Actual): May 29, 2026

Study Registration Dates

• First Submitted: June 27, 2026
• First Submitted That Met QC Criteria: June 27, 2026
• First Posted (Actual): July 2, 2026

Study Record Updates

• Last Update Posted (Actual): July 2, 2026
• Last Update Submitted That Met QC Criteria: June 27, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Therapeutics; Physical Therapy Modalities; Patient Care; Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Exercise; Muscle Stretching Exercises
• Other Study ID Numbers: 2025/16-42

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be publicly shared because explicit consent for external data sharing was not obtained from participants.

Drug and device information, study documents

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