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NCT Number: NCT07785427

Effect of Mechanically Loaded Neuro-dynamics in Subjects With Thoracic Outlet Syndrome

the study was done to: To assess the effect of Mechanically Loaded Neuro-dynamics on pain reduction in subjects with thoracic outlet syndrome.

To assess the effect of Mechanically Loaded Neuro-dynamics on shoulder range of motion in subjects with thoracic outlet syndrome.

To assess the effect of Mechanically Loaded Neuro-dynamics on clinical provocative tests in subjects with thoracic outlet syndrome.

To assess the effect of Mechanically Loaded Neuro-dynamics on neurophysiological findings in subjects with thoracic outlet syndrome.

To assess the effect of Mechanically Loaded Neuro-dynamics on quality of life and psychological status in subjects with thoracic outlet syndrome.

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Key information

Conditions

Thoracic Outlet Syndrome Cardiovascular Diseases Mechanically Loaded Neuro-dynamics Nerve Compression Syndromes Nervous System Diseases Neuromuscular Diseases Peripheral Nervous System Diseases Vascular Diseases

Age range

24 year–37 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

out-patient clinic, faculty of physical therapy - Kafrelsheikh University.

Kafr ash Shaykh, Egypt

Location contact

Mohammed Abdulmohsen Almohamadi, physical therapist

CONTACT

[email protected]

01050366830

About this study

Thoracic outlet syndrome (TOS) involves symptoms from the compression of neurovascular structures at three key sites: the costoclavicular junction, scalene triangle, and pectoralis minor space. It is categorized into three types: neurogenic Thoracic outlet syndrome, arterial Thoracic outlet syndrome, and venous Thoracic outlet syndrome, with neurogenic Thoracic outlet syndrome being the most common. Management typically involves conservative methods such as exercise rehabilitation, which aims to relieve symptoms by increasing thoracic outlet space. However, current literature lacks comprehensive reviews on exercise protocols. Mechanical loaded neuro-dynamics is introduced as a promising rehabilitation approach for athletes, focusing on enhancing neural and vascular mobility through controlled loading. Provocative tests are crucial for diagnosing Thoracic outlet syndrome , targeting the specific mechanisms of compression. Additionally, electro-neuro-graphical examinations play a vital role in diagnosing neurogenic Thoracic outlet syndrome by revealing abnormalities in nerve impulse transmission.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Subjects from both genders diagnosed with Thoracic Outlet Syndrome will be recruited through direct referrals from their neurosurgeon.
  • Subjects age between 30.8±7.4 years
  • Subjects body mass index = 19.5±2.8
  • Control group includes health volunteer subjects with negative root test results under supervision of neurosurgeon.

Exclusion criteria

The exclusion criteria are:

  • head injury, stroke.
  • epilepsy episodes.
  • mental disorders.
  • cardiovascular disease.
  • having a pacemaker or cochlear implant.
  • pregnancy, oncological episodes, inflammatory disease, myelopathy, degenerative changes in the cervical spine (after verification on computed tomography or magnetic resonance imaging scans).
  • peripheral neuropathies from the level of the arm and COVID-19-related symptoms

Treatment and study plan

Mechanically Loaded Neuro-dynamics

Other

Physical therapy management will include 11 visits over 11 weeks, utilizing green medium-resistance bands (4.6-6.9 pounds at 100% elongation). The protocol involves: weeks 3-4 with low tension isometric holds (5-10 seconds) in partial range; weeks 5-7 with dynamic repetitions (10-15 repetitions, 3 sets) in full range; and weeks 8-11 featuring sport-specific load progression with cycling postures and upper extremity tasks. Repetitions will be slow and controlled, with cues to minimize guarding or Valsalva. Progression will depend on symptom response and visual analogue scale scores, with Mechanically Loaded Neuro-dynamics performed 1-2 times weekly in-clinic and daily home exercises.

Traditional physical therapy program

Other

traditional physical therapy program

Primary outcomes

  1. assessment of Active and passive Range of motion

    Time frame: At baseline and after 11 weeks

    Cervical spine range of motion (ROM) was assessed using a goniometer. Participants were positioned comfortably in a standardized sitting position, with the trunk stabilized to minimize compensatory movements. Cervical flexion, extension, lateral flexion, and rotation were measured in degrees. The goniometer was aligned according to standard anatomical landmarks for each movement, and the active ROM was recorded at the end of the available pain-free range. Measurements were performed consistently for all participants under the same testing conditions.

Secondary outcomes

  1. assessment of sensory nerve conduction velocity

    Time frame: At baseline and after 11 weeks

    For the digital sensory nerve conduction study, we will use standard antidromic techniques with a fixed distance of 11 cm between the recording and stimulating electrodes for the ulnar and 13 cm for the median sensory nerves. Standard techniques and distances between recording and stimulating electrodes will be used for the medial antebrachial cutaneous (12 cm), lateral antebrachial cutaneous (12 cm), and the dorsal ulnar cutaneous (8 cm) nerve conduction study. Sensory nerve conduction study parameters included sensory nerve action potential, amplitude and peak latency

  2. assessment of motor nerve conduction velocity

    Time frame: At baseline and after 11 weeks

    For motor nerve conduction study, also will be used a fixed distance of 7 cm between the recording and stimulating electrodes for both median and ulnar nerves. motor nerve conduction study parameters included compound muscle action potential amplitude, area, distal latency, duration of the negative phase, and forearm conduction velocity.

  3. assessment of physical function and symptoms of the upper limb

    Time frame: At baseline and after 11 weeks

    The Disabilities of the Arm, Shoulder and Hand is a 30-item instrument assessing health status in daily activities, symptoms, social functioning, and psychological factors over the past week. Responses range from 1 (no difficulty) to 5 (unable to perform), yielding scores from 0 to 100, where higher scores indicate greater disability. The he Disabilities of the Arm, Shoulder and Hand demonstrates strong reliability, with an intraclass correlation coefficient of 0.74-0.95. The minimum detectable change is 11 points, while the minimum clinically important difference is 10.83 points, indicating significant changes in patient function.

Study contacts

Contact information is provided by the study sponsor or research team.

Mohammed Abdulmohsen Almohamadi, physical therapist

CONTACT

[email protected]

01050366830

Sponsors and collaborators

Lead sponsor

Kafrelsheikh University

Other

Registry information

Official study title

Effect of Mechanically Loaded Neuro-dynamics on Physiological Findings and Functional Outcomes in Subjects With Thoracic Outlet Syndrome

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Aug 25, 2026
Registry last updated
Aug 25, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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