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

21. august 2026 oppdatert av: 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.

Studieoversikt

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Antatt)

36

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

      • Kafr ash Shaykh, Egypt
        • out-patient clinic, faculty of physical therapy - Kafrelsheikh University.
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen

Tar imot friske frivillige

Nei

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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.
Aktiv komparator: traditional physical therapy program
involved 18 participants and received a traditional physical therapy program for Thoracic Outlet Syndrome (TOS)
traditional physical therapy program

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
assessment of Active and passive Range of motion
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
assessment of sensory nerve conduction velocity
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. september 2026

Primær fullføring (Antatt)

1. november 2026

Studiet fullført (Antatt)

1. desember 2026

Datoer for studieregistrering

Først innsendt

21. august 2026

Først innsendt som oppfylte QC-kriteriene

21. august 2026

Først lagt ut (Faktiske)

25. august 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

25. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

21. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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