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Effects of Median Nerve Neural Mobilization in Treating Cervicobrachial Pain: A Randomized Waiting List–Controlled Clinical Trial
Author(s) -
RodríguezSanz David,
LópezLópez Daniel,
UndaSolano Francisco,
RomeroMorales Carlos,
SanzCorbalán Irene,
BeltranAlacreu Hector,
CalvoLobo César
Publication year - 2018
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12614
Subject(s) - medicine , randomized controlled trial , dash , physical therapy , confidence interval , range of motion , manual therapy , clinical trial , physical medicine and rehabilitation , surgery , alternative medicine , pathology , computer science , operating system
Background There is a current lack of sufficiently high‐quality randomized controlled clinical trials that measure the effectiveness of neural tissue mobilization techniques such as median nerve neural mobilization ( MNNM ) and their specific effects on cervicobrachial pain ( CP ). The aim of this study was to compare the effectiveness of MNNM in subjects with CP vs. a waiting list control group ( WLCG ). Methods A single‐blinded, parallel, randomized controlled clinical trial was performed ( NCT 02596815). Subjects were recruited with a medical diagnosis of CP corroborated by magnetic resonance imaging. In total, 156 individuals were screened, 60 subjects were recruited, and 51 completed the trial. Pain intensity reported using the Numeric Rating Scale for Pain ( NRSP ; primary outcome), cervical range of motion ( CROM ), and functionality using the Quick Disabilities of the Arm, Shoulder and Hand ( Quick DASH ) scale were the outcome measurements. Assessments were conducted at baseline and 1 hour after treatment (intervention days 1, 15, and 30). Therefore, MNNM was implemented with 30 days of follow‐up. Results The NRSP values of the MNNM group were significantly ( P < 0.0001; 95% confidence interval [ CI ]) superior to those obtained in the WLCG . Subjects treated with MNNM reported an NRSP decrease of 3.08 points at discharge. CROM and Quick DASH outcome values were significantly ( P ˂ 0.0001; 95% CI ) improved only in the MNNM group. Hedges′ g showed a very large effect of the MNNM intervention. Conclusion MNNM may be superior to no treatment in reducing pain and increasing function in the affected upper limbs of subjects with CP .