Elongation Longitudinal Decoaptation Ostéo-Articulaire Versus Active Isolated Stretching on Median Nerve Mobility and Pain in Patient With Upper Limb Overuse Syndrome

July 10, 2026 updated by: Rubina Zulfqar, University of Faisalabad

Upper-limb overuse syndrome (ULOS) often arises from repetitive loading, altering cervical biomechanics and increased median-nerve mechano sensitivity. Elongation longitudinal decoaptation ostéo-articulaire (ELDOA) at C5-C6 improves segmental decompression and neural sliding, while Active isolated stretching (AIS) enhances soft tissue elasticity and neuro dynamic glide.

Currently no direct comparison exists between these two methods in literature. Study aims to compare ELDOA (C5-C6 specific) and AIS in patients with ULOS for checking effects on median nerve mobility and pain. This research will be conducted as a randomized clinical trial involving 84 participants (42 in each group). Adults aged 20-50 years with diagnosis of ULOS, symptom duration 3- months (12 weeks) will be included in the study. While Neurological or rheumatologic conditions, recent corticosteroid injections, recent cervical or major upper limb surgery, and ongoing neural mobilization-focused physical therapy are among the exclusions. After meeting the inclusion and exclusion criteria and obtaining written and verbal consent from the participants. Participants will be randomly assigned to either the AIS or ELDOA groups and will receive 3 sessions per week for 3 weeks with baseline hot pack. Group A will perform diaphragmatic breathing with ELDOA targeting C5-C6, whereas Group B will engage in AIS on muscles that cause median-nerve tension. Pain intensity, upper limb function and median nerve mobility are outcome measures that will be assessed using tools NPRS, QuickDASH and ULTT1. Data will be analyzed using the 2024 SPSS.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

84

Phase

  • 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 Locations

  • Pakistan
    • Punjab Province
      • Faisalabad, Punjab Province, Pakistan, 38000
        • Recruiting
        • Dr . Rubina Zulfqar

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

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • All adult age group (20-50 years) patients with clinical symptoms and signs of upper limb overuse syndrome with median nerve were included in the study (Latif et al., 2022).
  • Participants included individuals engaged in repetitive upper-limb activities, such as office workers, manual laborers, athletes and students, who demonstrated median nerve involvement associated with repetitive task performance (Descatha et al., 2017).
  • Persistent pain in the upper limb, pain intensity score from 3-7 on the Numeric pain rating scale (NPRS), discomfort and functional limitations in daily activities, occupational tasks or recreational activities were deemed to be indications of eligibility for participation in the study (Hawker et al., 2011).
  • Participants with persistent nature symptoms (3 months or more than 3 months) are included in the study to secure homogenous study population (Nicholas et al., 2019).
  • Willing to give their informed consent and take part.

Exclusion Criteria:

  • Trauma, surgery, fracture or dislocation of the upper limb in the last six months or less were excluded to minimize the possibility of studying the acute tissue healing on the results of this study (Cools et al., 2021).
  • Other neurological conditions (e.g., peripheral or central nervous system disorders, systemic neuropathies, cervical radiculopathy, or other neurological disorders) were excluded for participation (Padua et al., 2020).
  • The potential effect of rheumatologic or inflammatory musculoskeletal disorders (rheumatoid arthritis, lupus, or other systemic inflammatory diseases) on pain and functional status was also a reason for exclusion (Smolen et al., 2020).
  • No corticosteroid uses or prior physical therapy within 3 months to reduce the potentially confounding effect of prior therapeutic interventions on study outcomes (Kolasinski et al., 2020).
  • Participants were excluded from the study if they had any contraindications to manual therapy treatment that could affect the safety of the intervention (e.g., vascular, severe osteoporosis, malignancy, acute infection, other conditions) (Puentedura et al., 2012).

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: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Elongation longitudinal decoaptation ostéo-articulaire (ELDOA)

  1. Hot pack application

    • A moist hot pack will be applied to the cervical and upper-limb region for 10 minutes prior to the main intervention.

  2. Patient education
  3. Home exercise program Elongation longitudinal decoaptation ostéo-articulaire (ELDOA) C5-C6 spinal segments will be the focus of ELDOA postures performed by participants assigned to ELDOA group. To improve neuromuscular engagement, each pose will be held for 30 seconds and performed five times while accompanied by guided diaphragmatic breathing. Each session of ELDOA intervention will last roughly 15 to 20 minutes in total. To optimize therapeutic efficacy and safety, the therapist will closely monitor symptoms during each session and make sure that each posture is executed and aligned correctly.
Procedure: Elongation longitudinal decoaptation ostéo-articulaire (ELDOA) and baseline

Common baseline treatment (both Groups) Prior to their designated intervention, both groups will receive the following standardized baseline treatment:

  1. Hot pack application
  2. Patient education
  3. Home exercise program Elongation longitudinal decoaptation ostéo-articulaire (ELDOA) C5-C6 spinal segments will be the focus of ELDOA postures performed by participants assigned to ELDOA group. To improve neuromuscular engagement, each pose will be held for 30 seconds and performed five times while accompanied by guided diaphragmatic breathing. Each session of ELDOA intervention will last roughly 15 to 20 minutes in total. To optimize therapeutic efficacy and safety, the therapist will closely monitor symptoms during each session and make sure that each posture is executed and aligned correctly.
Experimental: Active isolated stretching (AIS)

  1. Hot pack application

    • A moist hot pack will be applied to the cervical and upper-limb region for 10 minutes prior to the main intervention.

  2. Patient education
  3. Home exercise program Active isolated stretching (AIS) Active Isolated stretches that target the wrist flexors, pronator teres, biceps and pectoralis minor muscles that affect median nerve tension will be performed by participants assigned to the AIS group 3 set of 8 to 10 repetitions of each stretch, held for two seconds, will be performed for every muscle group. Each session of AIS intervention will last roughly 15 to 20 minutes in total to maximize safety and efficacy. The therapist will keep an eye on technique, make sure that proper activation is occurring and evaluate stretch tolerance throughout the intervention.
Procedure: Active isolated stretching (AIS)
  1. Hot pack application
  2. Patient education.
  3. Home exercise program Active isolated stretching (AIS) Active Isolated stretches that target the wrist flexors, pronator teres, biceps and pectoralis minor muscles that affect median nerve tension will be performed by participants assigned to the AIS group 3 set of 8 to 10 repetitions of each stretch, held for two seconds, will be performed for every muscle group. Each session of AIS intervention will last roughly 15 to 20 minutes in total to maximize safety and efficacy. The therapist will keep an eye on technique, make sure that proper activation is occurring and evaluate stretch tolerance throughout the intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain intensity
Time Frame: 3 weeks
Pain intensity will be measured by using numeric pain rating scale
3 weeks
Functional status/ Disability
Time Frame: 3 weeks
Functional status/ Disability will be measured by using QuickDASH questionnaire, The lower the Quick DASH score, the better the upper limb function and fewer the activity limitations.
3 weeks
Nerve mobility
Time Frame: 3 weeks
Nerve mobility will be measured by using Upper Limb Tension Test (ULTT1), Better responses in the ULTT1 suggest better median nerve mobility and lower neural tension.
3 weeks

Collaborators and Investigators

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

Sponsor

University of Faisalabad

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 (Estimated)

July 10, 2026

Primary Completion (Estimated)

August 20, 2026

Study Completion (Estimated)

August 25, 2026

Study Registration Dates

First Submitted

June 8, 2026

First Submitted That Met QC Criteria

July 10, 2026

First Posted (Actual)

July 14, 2026

Study Record Updates

Last Update Posted (Actual)

July 14, 2026

Last Update Submitted That Met QC Criteria

July 10, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • Tuf/EIRB/170/26

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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