Elbow Injuries and Disorders, Neuritis, Brachial, Neuritis Median Nerve, Neuritis; Nerve Root, Neuritis, Ulnar
Conditions
Keywords
Regional Interdependence, Posture, Neural Tension, Physical Therapy
Brief summary
This study is investigating the effect of using a regional interdependence approach of managing non-structural elbow pain with physical therapy.
Detailed description
Potential patients will be referred for physical therapy with elbow nerve pain arising from a non-structural lesion. We believe by addressing spine and trunk posture and mobility we can relieve elbow pain associated with a nerve compression with physical therapy. Patients will be put on a staged exercise program to regain spinal mobility and strengthen proximal core musculature and scapular musculature. Manual therapy to facilitate mobility will be incorporated. Patients will undergo standard physical therapy by an unblinded therapist until resolution of symptoms.
Interventions
OTHERRehabiltiation using exercise and manual therapy
A licensed Physical Therapist will provide manual therapy to help restore spinal and scapular mobility. In association with this patients will be prescribed home exercises using a phased approach. Phase 1 to gain mobility of the spine and scapular motor control Phase 2 to gain shoulder mobility to strengthen scapular and spine musculature Phase 3 shoulder strengthening with long lever arms.
Sponsors
Bluegrass Orthopedics
Timothy Uhl
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Cohort longitudinal
Eligibility
Sex/Gender
ALL
Age
15 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* The patient presents with elbow pain that is not exacerbated with resisted wrist flexion, extension, supination, or pronation. * The patient presents with elbow pain that is not exacerbated with passive wrist flexion or extension. * The patient presents with three of the four positive cervical radicular signs * Patient presents with peripheral paresthesia
Exclusion criteria
* The patient reports a surgical history involving the elbow. * The patient has an MRI that is positive for structural deficits within the upper extremity. * The patient self-reports a diagnosis of rheumatoid arthritis or other neurological systemic diseases such as Parkinson's disease, cerebrovascular accident, multiple sclerosis, or similar conditions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Cervical Range of Motion in extension | Baseline and every 5th visit up to discharge which is estimated to be 3 months on average | Inclinometer measurement of cervical extension |
| Change in Focus On Therapeutic Outcome (FOTO) Patient Outcme Score | Baseline and every 5th visit up to discharge which is estimated to be 3 months on average | Patient self-report of perceived level of function. Scores range from 0 = low function, to 100=high function. |
| Change in Lower Trapezius scapular muscle strength | Baseline and every 5th visit up to discharge which is estimated to be 3 months on average | Objectively measure with hand held dynamometer for scapular retraction |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Elbow Flexion Range of Motion in Ulnar Nerve Tension position | Baseline and every 5th visit up to discharge which is estimated to be 3 months on average | Goniometric measure using a standard plastic goniometer with patient plased In nerve tension position that bias tension on ulnar nerve. The standard upper limb tension test position described by Magee' Orthopaedic Physical Assessment 7th edition. The angle of elbow flexion that reproduces symptoms will be recorded. Values will range from 0-150 degrees with a higher numbers indicating less symptoms. |
| Change in Elbow Extension Range of Motion in Median Nerve Tension positoin | Baseline and every 5th visit up to discharge which is estimated to be 3 months on average | Goniometric measure using a standard plastic goniometer with patient plased In nerve tension position that bias tension on median nerve. The standard upper limb tension test position described by Magee' Orthopaedic Physical Assessment 7th edition. The angle of elbow extension that reproduces symptoms will be recorded. Values will range from 0-150 degrees with a lower numbers indicating less symptoms. |
Countries
United States
Outcome results
None listed