Grip, Hand, Nerve
Conditions
Keywords
Neurodynamic Tensioning, Grip Strengthening, Resistance Training, Healthy Adults
Brief summary
This randomized controlled trial will investigate whether adding neurodynamic tensioning to a grip strengthening program provides additional improvements in hand grip strength in healthy adults. Sixty participants aged 18 to 40 years will be randomly assigned to two groups. Both groups will perform a standardized grip strengthening program for six weeks, three days per week. The experimental group will additionally receive neurodynamic tensioning exercises targeting the median and ulnar nerves. Hand grip strength will be assessed at baseline, week 3, and week 6. The study aims to determine whether neurodynamic tensioning provides additional benefit beyond grip strengthening alone.
Detailed description
This study is designed as a prospective, two-arm, parallel-group randomized controlled trial investigating the additional effects of neurodynamic tensioning on hand grip strength in healthy adults. A total of 60 participants aged 18 to 40 years will be enrolled and randomly allocated in a 1:1 ratio to either a control group or an experimental group using computer-based block randomization. Participants in both groups will perform a standardized grip strengthening program using an adjustable hand gripper for six weeks, three sessions per week. Each session will include three sets of 8-12 repetitions, with progressive resistance according to participant performance and perceived exertion. In addition to the same grip strengthening program, participants in the experimental group will receive neurodynamic tensioning targeting the median and ulnar nerves. Neurodynamic techniques will be performed within pain-free limits using controlled tensioning movements. For each nerve, three sets of 10 repetitions will be performed before the grip strengthening exercises. The primary outcome will be hand grip strength, measured using a Jamar hand dynamometer or an equivalent valid and reliable hand dynamometer. Grip strength will be assessed in standardized and different upper-extremity positions. Secondary outcomes will include pinch strength, manual dexterity, perceived exertion, intervention adherence, and adverse events. Assessments will be performed at baseline (T0), week 3 (T1), and week 6 (T2). The outcome assessor will be blinded to group allocation. The main analysis will evaluate group, time, and group-by-time interaction effects to determine whether adding neurodynamic tensioning to grip strengthening results in greater improvement in hand grip strength than grip strengthening alone.
Interventions
OTHERGrip Strengthening Program
Participants will perform a standardized grip strengthening program using an adjustable hand gripper with the dominant hand for six weeks, three sessions per week. Each session will consist of 3 sets of 8-12 repetitions, with approximately 2 seconds of gripping and 2 seconds of relaxation per repetition. Rest periods of 60-90 seconds will be provided between sets. Resistance will be progressively adjusted according to performance and perceived exertion.
OTHERNeurodynamic Tensioning
Neurodynamic tensioning targeting the median and ulnar nerves will be applied before the grip strengthening program. For each nerve, 3 sets of 10 repetitions will be performed, with each repetition consisting of approximately 4-5 seconds of controlled rhythmic tensioning. A 30-second rest period will be provided between sets. The technique will be performed within pain-free limits, producing only a mild stretching sensation.
Sponsors
Tokat Gaziosmanpasa University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Masking description
The outcome assessor will be blinded to group allocation. Participants and the physiotherapist delivering the interventions cannot be blinded because of the nature of the interventions.
Intervention model description
Participants will be randomly assigned in a 1:1 ratio to two parallel groups: grip strengthening alone or neurodynamic tensioning combined with grip strengthening. Both groups will be followed for six weeks.
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* Aged between 18 and 40 years. * Willing to participate voluntarily in the study. * No history of upper-extremity pain, injury, or surgery within the previous three months. * No diagnosed neurological, rheumatological, or systemic disease affecting the peripheral nervous system. * Sufficient cognitive ability to understand and follow the study protocol.
Exclusion criteria
* History of carpal tunnel syndrome, cervical radiculopathy, peripheral neuropathy, or upper-extremity entrapment neuropathy. * History of upper-extremity fracture or surgery within the previous six months. * Regular participation in grip strengthening exercises or intensive upper-extremity resistance training. * Use of medication that may affect neuromuscular performance.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Hand Grip Strength | Baseline, Week 3, and Week 6 | Hand grip strength of the dominant hand will be measured in kilograms (kg) using a Jamar hand dynamometer or an equivalent valid and reliable hand dynamometer. Measurements will be performed in three upper-extremity positions: standard seated position with the elbow at 90 degrees of flexion, elbow extension with the shoulder in a neutral position, and shoulder at 90 degrees of flexion with the elbow extended. Three trials will be performed in each position, and the mean of the three measurements will be used for analysis. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pinch Strength | Baseline, Week 3, and Week 6 | Pinch strength will be assessed using a pinch gauge, if available, including lateral and/or palmar pinch measurements. Measurements will be performed on the dominant hand, and changes over time will be compared between groups. |
| Change in Manual Dexterity | Baseline, Week 3, and Week 6 | Manual dexterity will be assessed using the Nine-Hole Peg Test or an equivalent valid and reliable manual dexterity test. Performance will be recorded at each assessment time point, and changes over time will be compared between groups. |
| Perceived Exertion During the Intervention | Baseline, Week 3, and Week 6 | Perceived exertion during the grip strengthening exercises will be recorded using a rating of perceived exertion (RPE). RPE will be used to monitor exercise intensity and guide progression of resistance throughout the intervention. |
Contacts
CONTACTUğur Sözlü, PhD
PRINCIPAL_INVESTIGATORUğur Sözlü, PhD
Tokat Gaziosmanpaşa Üniversitesi
Outcome results
None listed