• Pain Pract · Apr 2018

    Randomized Controlled Trial Multicenter Study

    Effects of Median Nerve Neural Mobilization in Treating Cervicobrachial Pain: A Randomized Waiting List-controlled Clinical Trial.

    • David Rodríguez-Sanz, Daniel López-López, Francisco Unda-Solano, Carlos Romero-Morales, Irene Sanz-Corbalán, Hector Beltran-Alacreu, and César Calvo-Lobo.
    • Physiotherapy Department, Physical Therapy & Health Sciences Research Group, Faculty of Health, Exercise and Sport, European University of Madrid, Villaviciosa de Odón, Madrid, Spain.
    • Pain Pract. 2018 Apr 1; 18 (4): 431-442.

    BackgroundThere 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).MethodsA single-blinded, parallel, randomized controlled clinical trial was performed (NCT02596815). 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 (QuickDASH) 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.ResultsThe 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 QuickDASH 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.ConclusionMNNM may be superior to no treatment in reducing pain and increasing function in the affected upper limbs of subjects with CP.© 2017 World Institute of Pain.

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