Efficacy of Combining Movement Representation Techniques to Active Neural Mobilization in the Mechanosensitivity of the Median Nerve in Asymptomatic Volunteers.

Efficacy of Combining Movement Representation Techniques to Active Neural Mobilization in the Mechanosensitivity of the Median Nerve: A Pilot Study, Single-blind,Randomized, Crossover.

The objective of this study will be to determine whether the combination of movement imaging techniques with neural mobilization (NM) exercises works to modify median nerve sensitivity to mechanical stimuli. Movement Representation Techniques (MRTs) are defined as therapeutic or training systems that neurophysiologically evoke a perceptual-cognitive representation of movement. They can be combined with the execution of actual movement or with afferent sensory stimulation (motor command). There is evidence demonstrating positive results in pain reduction and improved range of motion using MRTs alone.

The study will be evaluated in 10 randomly selected asymptomatic volunteers, considering the following variables: pressure pain threshold, elbow extensor range of motion, and sensory responses before and after the intervention, in both the experimental and control groups. The period between interventions will be 72 hours.

The objective of this pilot study will be to determine the efficacy of combining movement representation techniques with neural mobilization (NM) exercises on median nerve mechanosensitivity. Movement representation techniques (MRTs) are defined as therapeutic or training systems that neurophysiologically evoke a perceptual-cognitive representation of movement through imagery or observation of motor actions. They can be combined with actual movement execution or with afferent sensory stimulation (motor command). There is evidence demonstrating positive results in pain reduction and range of motion gains using MRTs alone.

The study will be designed as a randomized, single-blind, crossover pilot clinical trial. In this study, 10 asymptomatic volunteers will be randomly selected and measured in the following variables: pressure pain threshold (PPT), elbow extensor range of motion (EROM), and the spatiotemporal distribution of pre- and post-intervention sensory responses in both the experimental group (RMM + MN) and the control group (MN). The washout period between interventions will be 72 hours.

Inclusion Criteria:

• asymptomatic volunteers of both sexes
• aged 18 to 45
• with no symptoms or history of disease in the cervical region, shoulder girdle, or upper limb.

Exclusion Criteria:

• history of surgery or trauma to the cervical spine, shoulder girdle, or upper limb;
• nonspecific shoulder pain;
• presenting symptoms of chronic pain in any region of the body;
• aphantasia (inability to create mental images);
• hypermobility;
• history of cancer or active disease;
• current infection;
• rheumatological disease;
• neurological and/or psychiatric disorders;
• altered sensation;
• current pregnancy;
• consumption of centrally acting medications;
• undergoing physiotherapy treatment in the last month;
• inability to understand the informed consent document;
• previous experience with median nerve provocation testing.