Effectiveness of Scapula Mobilization on Mechanosensitivity of Upper Limb Neural Test 1 in Mechanical Neck Pain

NCT ID: NCT04168476

Last Updated: 2020-10-19

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-12-01
• Study Completion Date: 2020-02-27

Brief Summary

Between 45% and 70% of the general population suffers neck pain at some point in their lives, making it one of the most frequent reasons for taking sick leave. Given its importance in physiotherapy at clinical level, we seek to observe how a scapular mobilization technique might influence the neural mechanosensitivity of the median nerve as measured by Upper Limb Neural Test 1 (ULNT1) on subjects with neck pain.

Hypotheses and objectives. Performing a scapular mobilization technique on subjects with neck pain and a positive ULNT1 improves the patient's response to said test. It also decreases the patient's neck pain as measured using a Visual Analog Scale (VAS) for pain and increases grip strength.

Material and method. A single-blind clinical trial was performed on subjects randomly assigned to either a treatment group or control group. The sample consisted of 60 subjects (N = 60) -30 in the treatment group (n = 30) and the other 30 as a control (n = 30) -and was made up of patients with neck pain and a positive ULNT1. A scapular mobilization was performed on the first group and on the second, a calcaneus abduction adduction on the opposite side from the positive ULNT1 as a placebo.

Detailed Description

Mechanical cervicalgia is a very frequent and important clinical picture in physiotherapy consultations. It can be considered as a pluripatology as it covers somatic, functional, psychological and social aspects. This ailment is suffered by between 45 and 70% of the general population during some period of life and is one of the most frequent justifications of work leave and the main cause of permanent disability. Mechanical cervicalgia significantly decreases the quality of life of those who suffer from it: it frequently produces a significant disability when generating pain, functional deficit, headaches, movement restriction, vertiginous syndromes, nausea and / or vomiting, etc. This leads to reduced work time and increased health system costs, causing a strong economic and social impact. For example, Borghouts JA and Cols point out that in the Netherlands in 1996 these costs were approximately 686 million dollars, which constituted 1% of total health expenditure and 0.1% of its Gross Domestic Product (GDP) . In Spain, referrals to the cervicalgia physiotherapy service represent 10% of the total of all health demands; in Britain this percentage reaches 15% and in Canada 30%. Likewise, it should be considered that the direct cost caused by cervicalgia to the health system in our country, specifically to the Primary Care consultation, constitutes 2% of the total, and in some centers this figure reaches up to 12% if they are considered diagnostic tests, pharmaceutical expenses and visits to the specialist.

Conditions

Neck Pain; Musculoskeletal Diseases

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Treatment group

Participants of this group were assessed by the examiner twice, pre and post intervention, having recorded two values for each of the following variables:

• Visual Analogue Scale
• Range of movement
• Hand grip strength. After a first assessment, scapula mobilization techniques were performed and participants reassessed.

Group Type: EXPERIMENTAL

Interscapular muscle release or scapular mobilization technique as described by Travell and Simons.

Intervention Type: OTHER

Patient is sidelying with the testing side up. The auditor stands in front of the patient, reaches over the patient's shoulder to grasp the upper portion of the vertebral border of the scapula, and the other arm reaches under the patient's humerus to grasp the lower portion of the vertebral border of the scapula.

The auditor then slowly moves the scapula into elevation/depression, internal/external rotation/abduction and adduction.

To standardize the technique and be able to reproduce it in each participant, a set of 10 repetitions for each movement was performed in the same order.

Control group

Participants of this group were assessed by the examiner twice, pre and post intervention, having recorded two values for each of the following variables:

• Visual Analogue Scale
• Range of movement
• Hand grip strength. The procedure was a contralateral calcaneus abduction and adduction mobilization technique was carried out.

Group Type: PLACEBO_COMPARATOR

Calcaneus abduction and adduction mobilization technique

Intervention Type: OTHER

Abduction and adduction mobilization of the calcaneus is carried out in the opposite side of the upper extremity measured.

Interventions

Interscapular muscle release or scapular mobilization technique as described by Travell and Simons.

Patient is sidelying with the testing side up. The auditor stands in front of the patient, reaches over the patient's shoulder to grasp the upper portion of the vertebral border of the scapula, and the other arm reaches under the patient's humerus to grasp the lower portion of the vertebral border of the scapula.

The auditor then slowly moves the scapula into elevation/depression, internal/external rotation/abduction and adduction.

To standardize the technique and be able to reproduce it in each participant, a set of 10 repetitions for each movement was performed in the same order.

Intervention Type: OTHER

Calcaneus abduction and adduction mobilization technique

Abduction and adduction mobilization of the calcaneus is carried out in the opposite side of the upper extremity measured.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Adults with mechanical cervicalgia and a positive median neurodynamic test (ULNT1) reproducing the patient's cervical pain.
• Sign the informed consent.

Exclusion Criteria

• Do not sign informed consent.
• Patients who, due to previous malformations or injuries, are not able to be positioned in the position described for the ULNT1 test.
• Congenital malformations of the cervical spine and / or upper limb.
• Previous spine surgery.
• Neurological pathologies diagnosed, such as diabetic polyneuritis or others.
• Refusal to participate in the study.

• Minimum Eligible Age: 22 Years
• Maximum Eligible Age: 79 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Aitor Vaquero Garrido

OTHER

Sponsor Role: lead

Responsible Party

Aitor Vaquero Garrido

Research Master

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Aitor Vaquero Garrido

Role: STUDY_CHAIR

University of Seville

Locations

Aitor Vaquero Garrido

Seville, , Spain

Countries

Spain

Other Identifiers

Upper Limb Neural Test 1

Identifier Type: -

Identifier Source: org_study_id