Cervico Brachialgia
Conditions
Keywords
Disability, Mobilization, Neural, Pain, Scapula
Brief summary
Cervicobrachialgia is a common musculoskeletal condition characterized by neck pain radiating into the upper limb due to neural and musculoskeletal dysfunctions. It is often associated with pain, functional disability, and increased neural mechanosensitivity, significantly affecting daily activities and quality of life. Various physiotherapy interventions have been used to manage this condition, including neural mobilization and scapulothoracic rehabilitation. However, evidence regarding the combined effectiveness of these interventions remains limited.
Detailed description
The aim of the study is to determine the effects of scapulothoracic intervention with or without neural mobilization on pain, function, and neural mechanosensitivity in patients with cervicobrachialgia. Methods: A randomized controlled trial will be conducted on 40 patients diagnosed with cervicobrachialgia. Participants will be randomly allocated into two groups, with 20 participants in each group. Group A received scapulothoracic rehabilitation combined with neural mobilization (ST+NM), while Group B received neural mobilization alone (NM). Treatment will be administered according to the study protocol over the intervention period. Outcome measures includes the Numeric Pain Rating Scale (NPRS) for pain intensity, Neck Pain Questionnaire (NPQ) for neck-related disability, PainDETECT Questionnaire (PDQ) for neuropathic pain symptoms, and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire for upper limb function. Assessments were performed before and after the intervention. Data will be analyzed using paired sample t-tests, independent sample t-tests, Mann-Whitney U tests, and Wilcoxon Signed Rank tests with a significance level of p\<0.05.
Interventions
OTHERScapulothoracic intervention with Neural Mobilization
Neural Mobilization: Pain-free tension 1. Scapular Mobilization: * Grades III-IV joint mobs (elevation/depression/retraction) * 3 sets × 10 reps 2. Strengthening: * Serratus punches (progress to resistance bands) * Lower trap raises (prone Y-lifts) * 3 sets × 12 reps 3. Neural Mobilization: * ULNT1 sliding technique (6 sec hold/6 sec rest)
OTHERNeural Mobilization
Neural Mobilization: Pain-free tension 1. Cervical Isometrics: * 4-way neck contractions (5-sec hold) * 3 sets × 10 reps 2. Postural Education: • Ergonomics training 3. Modalities: • TENS (80Hz, 100μs) or moist heat pack 4. Neural Mobilization: * ULNT1 (same as Group A)
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
30 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Cervicobrachial pain * Females and males * Aged 30-50 years * Able to communicate and follow the instructions * Able to perform cervical exercises according to cervicogenic pain
Exclusion criteria
* Negative neurodynamic test * Neck and upper extremity surgery * Vertebral instability * Vertebral spine infection * Neurological disease of genetic, infection, or neuroplastic origin * Inflammatory or systemic disease * VBI symptoms * Rheumatoid arthritis * Subjects with presence of any fractures. * Heart/diabetic patient
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analogue Scale (VAS) | upto 6 weeks | The VAS is a common, subjective measurement tool that is used to measure the level of pain severity using an 11-point range with zero (no pain) and ten (heaviest pain imaginable). Patients use a subjective scale to rate their pain verbally and the following scales apply to 1-3 mild, 4-6 moderate, and 7-10 severe pain. |
| Northwick Park Neck Pain Questionnaire (NPQ) | upto 6 weeks | The NPQ is a 9- questionnaire assessing neck pain disability with each question put on a scale of 0 to 4(code converted to percentage). It examines nocturnal sleep, activities during the day, and social goals. With cervicobrachialgia, it is used to measure functional restrictiveness such as neck/arm pain. Scores: 0-20 percent (light), 21-40 percent (moderate), \>40 percent (severe). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PainDETECT questionnaire (PD-Q) | upto 6 weeks | It is a 9-item instrument that has 7 scored items 0-5, and 2 items of the pain pattern characteristics of neuropathic pain in cervicobrachialgia. score 0-38: \<13 (not likely neuropathic), 13-18 (indeterminate), \>=19 (probable neuropathic). It assesses the quality of pain (burning, tingling etc.), radiation patterns. |
| Disability of Arm, Shoulder and Hand (DASH) | upto 6 weeks | The DASH assesses upper limb disability and is a 30 item questionnaire scaled 1-5. The total point (0-100) is counted: \[(the sum of the responses/n) -1\] x 25. The higher the score and the more they are disabled. The course is minimal clinically significant difference, 10 points. In case of cervicobrachialgia, it examines the impairment of arm functioning. |
| FABF Questionnaire (FABQ) | upto 6 weeks | FABQ contains 16 items consisting of two subscales namely, physical activity (4 items, 0-24) and work (7 items, 0-42). The more the score, the higher fear-avoidance. In cervicobrachialgia, scores above 14 (work) or 12 (physical activity), predict an unsatisfactory recovery. |
Contacts
CONTACTSumrod Akram
PRINCIPAL_INVESTIGATORRamish Safraz
Riphah International University
Outcome results
None listed