Double Crush Syndrome
Conditions
Keywords
cervical mobilization, hand function, double crush syndrome
Brief summary
All Double Crush Syndrome patients were assessed via VAS, BCTQ & Nerve conduction study before and after the treatment program.
Detailed description
The patients were classified randomly into two groups, the control group received a standard physical therapy program of nerve glide, hand strengthening exercise and mobilization and the study group they received a cervical mobilization in addition to the standard physical therapy program for 12 sessions.
Interventions
The technique is used to mobilize a specific cervical or upper thoracic segment (C2-C3 through T3-T4) in a posterior to anterior direction. The therapist gently applies pressure in an anteroposterior direction in the plane of the facet joint to assess mobility, resistance, end feel, and pain provocation. Gentle oscillations can be used to either inhibit pain (grades I and II) or restore motion (grades III and IV). Slight variations in depth and direction of force can be used to optimize the therapeutic effects of this technique.
tendon gliding exercises, median nerve gliding exercise, strengthening exercises for 60 minutes
Sponsors
Ahmed Alshimy
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
FEMALE
Age
25 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
* Thirty female patients diagnosed as Double Crush Syndrome based on the clinical diagnostic criteria of the American Academy of Neurology, (American Academy of Neurology 2019). * Patient ages ranged from 25 to 35 years old. Patient who reported pain, hyperesthesia, and/or paresthesia at the course of median nerve distribution and upper limb. * A Nerve Conduction Study (NCS) evidence of peripheral entrapment of median nerve at level of carpal bone Carpal tunnel Syndrome with a fractionated sensory nerve conduction velocity for the median nerve across the wrist of 40 m/s or less and with sensory peak latency \> 3.6 ms and recordable and with motor distal latency \>4.4 ms and less than 6.5ms.
Exclusion criteria
* Patients had Systemic disease causes double Crush Syndrome as rheumatoid arthritis (RA), thyroid disease, Diabetes mellitus (DM), Pregnant women, Patients with concomitant neurological disease as peripheral neuropathy, Patients with history of wrist surgery, fracture, or carpal tunnel injection in the last two weeks before the study, Patients who have wasting of the thenar muscles, Patients with previous surgery for CTS. * Patients with complete conduction block on EDX or previous regular exposure to hand-held vibrating tools, Patients with Nerve Conduction Study with motor distal latency \> 6.5 ms.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual analogue scale | 4 weeks | Used to assess degree of pain |
| Boston carpal tunnel syndrome questionnaire | 4 weeks | Used to assess patients' functional ability and symptoms severity |
| Nerve conduction study | 4 weeks | Used to assess sensory and motor fibers of median nerve to determine the improvement in nerve capacity and hand function |
Countries
Egypt
Outcome results
None listed