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

21 août 2026 mis à jour par: 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.

Aperçu de l'étude

Description détaillée

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.

Type d'étude

Interventionnel

Inscription (Estimé)

36

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

  • Nom: Mohammed Abdulmohsen Almohamadi, physical therapist
  • Numéro de téléphone: 01050366830
  • E-mail: ptmohammed1993@gmail.com

Lieux d'étude

      • Kafr ash Shaykh, Egypte
        • out-patient clinic, faculty of physical therapy - Kafrelsheikh University.
        • Contact:
          • Mohammed Abdulmohsen Almohamadi, physical therapist
          • Numéro de téléphone: 01050366830
          • E-mail: ptmohammed1993@gmail.com

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte

Accepte les volontaires sains

Non

La description

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 d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Seul

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: 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.
Comparateur actif: traditional physical therapy program
involved 18 participants and received a traditional physical therapy program for Thoracic Outlet Syndrome (TOS)
traditional physical therapy program

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
assessment of Active and passive Range of motion
Délai: 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

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
assessment of sensory nerve conduction velocity
Délai: 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
Délai: 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
Délai: 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

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

1 septembre 2026

Achèvement primaire (Estimé)

1 novembre 2026

Achèvement de l'étude (Estimé)

1 décembre 2026

Dates d'inscription aux études

Première soumission

21 août 2026

Première soumission répondant aux critères de contrôle qualité

21 août 2026

Première publication (Réel)

25 août 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

25 août 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

21 août 2026

Dernière vérification

1 août 2026

Plus d'information

Termes liés à cette étude

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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