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Completed

NCT Number: NCT05537636

Physical Therapy on Non-structural Medial Elbow Pain

This study is investigating the effect of using a regional interdependence approach of managing non-structural elbow pain with physical therapy.

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Key information

Conditions

Elbow Injuries and Disorders Arm Injuries Brachial Plexus Neuritis Brachial Plexus Neuropathies Disease Elbow Injuries Mononeuropathies Nervous System Diseases Neuritis Neuritis Median Nerve Neuritis, Brachial Neuritis, Ulnar Neuritis; Nerve Root Neuromuscular Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Peripheral Nervous System Diseases Ulnar Neuropathies Wounds and Injuries

Age range

15 year–50 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Bluegrass Orthopaedics

Lexington, Kentucky, 40509, United States

About this study

Potential patients will be referred for physical therapy with elbow nerve pain arising from a non-structural lesion. We believe by addressing spine and trunk posture and mobility we can relieve elbow pain associated with a nerve compression with physical therapy.

Patients will be put on a staged exercise program to regain spinal mobility and strengthen proximal core musculature and scapular musculature. Manual therapy to facilitate mobility will be incorporated. Patients will undergo standard physical therapy by an unblinded therapist until resolution of symptoms.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • The patient presents with elbow pain that is not exacerbated with resisted wrist flexion, extension, supination, or pronation.
  • The patient presents with elbow pain that is not exacerbated with passive wrist flexion or extension.
  • The patient presents with three of the four positive cervical radicular signs
  • Patient presents with peripheral paresthesia

Exclusion criteria

  • The patient reports a surgical history involving the elbow.
  • The patient has an MRI that is positive for structural deficits within the upper extremity.
  • The patient self-reports a diagnosis of rheumatoid arthritis or other neurological systemic diseases such as Parkinson's disease, cerebrovascular accident, multiple sclerosis, or similar conditions

Treatment and study plan

Rehabiltiation using exercise and manual therapy

Other

A licensed Physical Therapist will provide manual therapy to help restore spinal and scapular mobility. In association with this patients will be prescribed home exercises using a phased approach.

Phase 1 to gain mobility of the spine and scapular motor control Phase 2 to gain shoulder mobility to strengthen scapular and spine musculature Phase 3 shoulder strengthening with long lever arms.

Primary outcomes

  1. Change in Cervical Range of Motion in extension

    Time frame: Baseline and every 5th visit up to discharge which is estimated to be 3 months on average

    Inclinometer measurement of cervical extension

  2. Change in Focus On Therapeutic Outcome (FOTO) Patient Outcme Score

    Time frame: Baseline and every 5th visit up to discharge which is estimated to be 3 months on average

    Patient self-report of perceived level of function. Scores range from 0 = low function, to 100=high function.

  3. Change in Lower Trapezius scapular muscle strength

    Time frame: Baseline and every 5th visit up to discharge which is estimated to be 3 months on average

    Objectively measure with hand held dynamometer for scapular retraction

Secondary outcomes

  1. Change in Elbow Flexion Range of Motion in Ulnar Nerve Tension position

    Time frame: Baseline and every 5th visit up to discharge which is estimated to be 3 months on average

    Goniometric measure using a standard plastic goniometer with patient plased In nerve tension position that bias tension on ulnar nerve. The standard upper limb tension test position described by Magee' Orthopaedic Physical Assessment 7th edition. The angle of elbow flexion that reproduces symptoms will be recorded. Values will range from 0-150 degrees with a higher numbers indicating less symptoms.

  2. Change in Elbow Extension Range of Motion in Median Nerve Tension positoin

    Time frame: Baseline and every 5th visit up to discharge which is estimated to be 3 months on average

    Goniometric measure using a standard plastic goniometer with patient plased In nerve tension position that bias tension on median nerve. The standard upper limb tension test position described by Magee' Orthopaedic Physical Assessment 7th edition. The angle of elbow extension that reproduces symptoms will be recorded. Values will range from 0-150 degrees with a lower numbers indicating less symptoms.

Sponsors and collaborators

Lead sponsor

Timothy Uhl

Other

Collaborators

  • Bluegrass Orthopedics

Registry information

Official study title

Effect of Regional Interdepence Physical Therapy Approach on Non-structural Medial Elbow Pain

Important dates

Study start
2022
Primary completion
2023
Study completion
2023
First posted
Sep 13, 2022
Registry last updated
Nov 22, 2023

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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