Neurodynamic Tensioning Plus Grip Strengthening for Hand Grip Strength

Overview

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.

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.