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| Name | Class |
|---|---|
| Bluegrass Orthopedics | UNKNOWN |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Regional Interdepence Intervention for the upper quarter | Experimental | Physical therapist will perform interventions to the entire uppper extremity and spine to treat elbow pain. Physical therapy intervention will include manual therapy and soft-tissue massage to the shoulder, cervical, and thoracic spine. Participants will be prescribed specific exercises using a phased approach. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Cervical Range of Motion in extension | Inclinometer measurement of cervical extension | 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. | 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 | Baseline and every 5th visit up to discharge which is estimated to be 3 months on average |
| Measure | Description | Time Frame |
|---|---|---|
| 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. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tim L Uhl, PhD | University of Kentucky | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bluegrass Orthopaedics | Lexington | Kentucky | 40509 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24421619 | Result | Sueki DG, Cleland JA, Wainner RS. A regional interdependence model of musculoskeletal dysfunction: research, mechanisms, and clinical implications. J Man Manip Ther. 2013 May;21(2):90-102. doi: 10.1179/2042618612Y.0000000027. | |
| 28878485 | Result | Wickstrom BM, Oakley PA, Harrison DE. Non-surgical relief of cervical radiculopathy through reduction of forward head posture and restoration of cervical lordosis: a case report. J Phys Ther Sci. 2017 Aug;29(8):1472-1474. doi: 10.1589/jpts.29.1472. Epub 2017 Aug 10. |
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| ID | Term |
|---|---|
| D000092464 | Elbow Injuries |
| D004194 | Disease |
| D020424 | Ulnar Neuropathies |
| D020968 | Brachial Plexus Neuritis |
| D009443 | Neuritis |
| ID | Term |
|---|---|
| D001134 | Arm Injuries |
| D014947 | Wounds and Injuries |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D026201 | Musculoskeletal Manipulations |
| ID | Term |
|---|---|
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |
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Cohort longitudinal
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|
| 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. | Baseline and every 5th visit up to discharge which is estimated to be 3 months on average |
| 24685569 | Result | Day JM, Willoughby J, Pitts DG, McCallum M, Foister R, Uhl TL. Outcomes following the conservative management of patients with non-radicular peripheral neuropathic pain. J Hand Ther. 2014 Jul-Sep;27(3):192-9; quiz 200. doi: 10.1016/j.jht.2014.02.003. Epub 2014 Feb 27. |
| 12544957 | Result | Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine (Phila Pa 1976). 2003 Jan 1;28(1):52-62. doi: 10.1097/00007632-200301010-00014. |
| 22402638 | Result | Nee RJ, Jull GA, Vicenzino B, Coppieters MW. The validity of upper-limb neurodynamic tests for detecting peripheral neuropathic pain. J Orthop Sports Phys Ther. 2012 May;42(5):413-24. doi: 10.2519/jospt.2012.3988. Epub 2012 Mar 8. |
| D020422 | Mononeuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D020516 | Brachial Plexus Neuropathies |