Physical Therapy on Non-structural Medial Elbow Pain

Timothy Uhl22 enrolled

Overview

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

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.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Elbow Injuries and Disorders Neuritis, Ulnar Neuritis, Brachial Neuritis; Nerve Root Neuritis Median Nerve

Interventions

Rehabiltiation using exercise and manual therapyOTHER

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.

Eligibility

Sex: ALLMin age: 15 YearsMax age: 50 Years

Medical Language ↔ Plain English

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

Locations (1)

Bluegrass Orthopaedics

Lexington, Kentucky, United States

Outcomes

Primary Outcomes

Change in Cervical Range of Motion in extension

Inclinometer measurement of cervical extension

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

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

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

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

Change in Lower Trapezius scapular muscle strength

Objectively measure with hand held dynamometer for scapular retraction

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

Secondary Outcomes

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

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.

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

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

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.

Data from ClinicalTrials.gov

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