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Effect of Mechanically Loaded Neuro-dynamics in Subjects With Thoracic Outlet Syndrome

21 de agosto de 2026 actualizado por: Mohammed Abdulmohasen Almohammdi, Kafrelsheikh University

Effect of Mechanically Loaded Neuro-dynamics on Physiological Findings and Functional Outcomes in Subjects With Thoracic Outlet Syndrome

the study was done to: To assess the effect of Mechanically Loaded Neuro-dynamics on pain reduction in subjects with thoracic outlet syndrome.

To assess the effect of Mechanically Loaded Neuro-dynamics on shoulder range of motion in subjects with thoracic outlet syndrome.

To assess the effect of Mechanically Loaded Neuro-dynamics on clinical provocative tests in subjects with thoracic outlet syndrome.

To assess the effect of Mechanically Loaded Neuro-dynamics on neurophysiological findings in subjects with thoracic outlet syndrome.

To assess the effect of Mechanically Loaded Neuro-dynamics on quality of life and psychological status in subjects with thoracic outlet syndrome.

Descripción general del estudio

Descripción detallada

Thoracic outlet syndrome (TOS) involves symptoms from the compression of neurovascular structures at three key sites: the costoclavicular junction, scalene triangle, and pectoralis minor space. It is categorized into three types: neurogenic Thoracic outlet syndrome, arterial Thoracic outlet syndrome, and venous Thoracic outlet syndrome, with neurogenic Thoracic outlet syndrome being the most common. Management typically involves conservative methods such as exercise rehabilitation, which aims to relieve symptoms by increasing thoracic outlet space. However, current literature lacks comprehensive reviews on exercise protocols. Mechanical loaded neuro-dynamics is introduced as a promising rehabilitation approach for athletes, focusing on enhancing neural and vascular mobility through controlled loading. Provocative tests are crucial for diagnosing Thoracic outlet syndrome , targeting the specific mechanisms of compression. Additionally, electro-neuro-graphical examinations play a vital role in diagnosing neurogenic Thoracic outlet syndrome by revealing abnormalities in nerve impulse transmission.

Tipo de estudio

Intervencionista

Inscripción (Estimado)

36

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

  • Nombre: Mohammed Abdulmohsen Almohamadi, physical therapist
  • Número de teléfono: 01050366830
  • Correo electrónico: ptmohammed1993@gmail.com

Ubicaciones de estudio

      • Kafr ash Shaykh, Egipto
        • out-patient clinic, faculty of physical therapy - Kafrelsheikh University.
        • Contacto:
          • Mohammed Abdulmohsen Almohamadi, physical therapist
          • Número de teléfono: 01050366830
          • Correo electrónico: ptmohammed1993@gmail.com

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

  • Adulto

Acepta Voluntarios Saludables

No

Descripción

Inclusion Criteria:

  1. Subjects from both genders diagnosed with Thoracic Outlet Syndrome will be recruited through direct referrals from their neurosurgeon.
  2. Subjects age between 30.8±7.4 years
  3. Subjects body mass index = 19.5±2.8
  4. Control group includes health volunteer subjects with negative root test results under supervision of neurosurgeon.

Exclusion Criteria:

The exclusion criteria are:

  1. head injury, stroke.
  2. epilepsy episodes.
  3. mental disorders.
  4. cardiovascular disease.
  5. having a pacemaker or cochlear implant.
  6. pregnancy, oncological episodes, inflammatory disease, myelopathy, degenerative changes in the cervical spine (after verification on computed tomography or magnetic resonance imaging scans).
  7. peripheral neuropathies from the level of the arm and COVID-19-related symptoms

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Único

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Mechanically Loaded Neuro-dynamics
involved 18 participants and received physical therapy management will include 11 visits over 11 weeks, Mechanically Loaded Neuro-dynamics was implemented using green medium-resistance bands (approximately 4.6-6.9 lbs. at 100% elongation).
Physical therapy management will include 11 visits over 11 weeks, utilizing green medium-resistance bands (4.6-6.9 pounds at 100% elongation). The protocol involves: weeks 3-4 with low tension isometric holds (5-10 seconds) in partial range; weeks 5-7 with dynamic repetitions (10-15 repetitions, 3 sets) in full range; and weeks 8-11 featuring sport-specific load progression with cycling postures and upper extremity tasks. Repetitions will be slow and controlled, with cues to minimize guarding or Valsalva. Progression will depend on symptom response and visual analogue scale scores, with Mechanically Loaded Neuro-dynamics performed 1-2 times weekly in-clinic and daily home exercises.
Comparador activo: traditional physical therapy program
involved 18 participants and received a traditional physical therapy program for Thoracic Outlet Syndrome (TOS)
traditional physical therapy program

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
assessment of Active and passive Range of motion
Periodo de tiempo: At baseline and after 11 weeks
Cervical spine range of motion (ROM) was assessed using a goniometer. Participants were positioned comfortably in a standardized sitting position, with the trunk stabilized to minimize compensatory movements. Cervical flexion, extension, lateral flexion, and rotation were measured in degrees. The goniometer was aligned according to standard anatomical landmarks for each movement, and the active ROM was recorded at the end of the available pain-free range. Measurements were performed consistently for all participants under the same testing conditions.
At baseline and after 11 weeks

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
assessment of sensory nerve conduction velocity
Periodo de tiempo: At baseline and after 11 weeks
For the digital sensory nerve conduction study, we will use standard antidromic techniques with a fixed distance of 11 cm between the recording and stimulating electrodes for the ulnar and 13 cm for the median sensory nerves. Standard techniques and distances between recording and stimulating electrodes will be used for the medial antebrachial cutaneous (12 cm), lateral antebrachial cutaneous (12 cm), and the dorsal ulnar cutaneous (8 cm) nerve conduction study. Sensory nerve conduction study parameters included sensory nerve action potential, amplitude and peak latency
At baseline and after 11 weeks
assessment of motor nerve conduction velocity
Periodo de tiempo: At baseline and after 11 weeks
For motor nerve conduction study, also will be used a fixed distance of 7 cm between the recording and stimulating electrodes for both median and ulnar nerves. motor nerve conduction study parameters included compound muscle action potential amplitude, area, distal latency, duration of the negative phase, and forearm conduction velocity.
At baseline and after 11 weeks
assessment of physical function and symptoms of the upper limb
Periodo de tiempo: At baseline and after 11 weeks
The Disabilities of the Arm, Shoulder and Hand is a 30-item instrument assessing health status in daily activities, symptoms, social functioning, and psychological factors over the past week. Responses range from 1 (no difficulty) to 5 (unable to perform), yielding scores from 0 to 100, where higher scores indicate greater disability. The he Disabilities of the Arm, Shoulder and Hand demonstrates strong reliability, with an intraclass correlation coefficient of 0.74-0.95. The minimum detectable change is 11 points, while the minimum clinically important difference is 10.83 points, indicating significant changes in patient function.
At baseline and after 11 weeks

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Estimado)

1 de septiembre de 2026

Finalización primaria (Estimado)

1 de noviembre de 2026

Finalización del estudio (Estimado)

1 de diciembre de 2026

Fechas de registro del estudio

Enviado por primera vez

21 de agosto de 2026

Primero enviado que cumplió con los criterios de control de calidad

21 de agosto de 2026

Publicado por primera vez (Actual)

25 de agosto de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

25 de agosto de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

21 de agosto de 2026

Última verificación

1 de agosto de 2026

Más información

Términos relacionados con este estudio

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

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