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The goal of this clinical trial is to discover whether performing active neural mobilization exercises works to manage chronic musculoskeletal pain in older adults. The main question it aims to answer is:
Can an active neural mobilization program improve pain intensity and functional capacity?
Participants will:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Active Neural Mobilization Exercises | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Active Neural Mobilization Exercises | Other | Participants will actively perform neural mobilization exercises for the upper and lower limbs, as well as spinal structures. |
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| Measure | Description | Time Frame |
|---|---|---|
| Pain diary | Participants will be asked to complete a daily "pain diary," recording:
| Every day (until the end of the study) - from week 1 to week 21 |
| Measure | Description | Time Frame |
|---|---|---|
| Pain distribution | A body chart to record the location and distribution of pain. | Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21) |
| Neuropathic pain components |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Medical Sciences, University of Aveiro (Portugal) | Aveiro | 3810-193 | Portugal |
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The experimental methodology selected to address the objectives of this study was a single-case experimental design (SCED) with multiple baseline design (MBD). Participants will alternate between three sequential phases: Phase A - baseline (1 to 4 weeks), Phase B - experimental phase (8 weeks), and Phase A' - follow-up (9 to 12 weeks). Phase B will have the same duration for all participants, while Phases A and A' will have different durations for each participant.
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painDETECT questionnaire - The instrument consists of 4 sections related to: (1) pain intensity in the last 4 weeks; (2) the pain pattern; (3) regions of pain; and (4) presence of neuropathic descriptors. The total score is obtained by adding the scores of the last 3 sections and can vary from 1 to 38. Scores ≤ 12 = the neuropathic mechanism is very unlikely to be present (predominance of the nociceptive mechanism); Scores ≥ 19 = there is a high probability of a predominant neuropathic mechanism; Scores > 12 and < 19 = the presence of a mixed component.
| Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21) |
| Pain Catastrophizing | Pain Catastrophizing Scale (PCS) - The instrument has 13 items subdivided into three different subscales: helplessness (items 1, 2, 3, 4, 5, and 12); magnification (items 6, 7, and 13); and rumination (items 8, 9, 10, and 11). All subscales are evaluated on a 5-point Likert scale, from 0 (not at all) to 4 (all the time), where higher scores represent a greater level of catastrophizing. | Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21) |
| Kinesiophobia | Tampa Scale for Kinesiophobia - The instrument comprises 13 items rated on a 4-point Likert scale, as follows: (1) strongly disagree; (2) somewhat disagree; (3) somewhat agree; (4) strongly agree. The higher the score, the greater the fear perceived during the execution of the movement. | Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21) |
| Signs and symptoms of hypersensitivity of the nervous system | Central Sensitization Inventory (CSI) - It assesses common symptoms and facilitating factors for hypersensitivity of the nervous system in 25 items. The patient scores each response on a scale from 0 (never) to 4 (always). The final score is obtained by summing the scores of the individual items and can range from 0 to 100, where higher scores mean a worse outcome. | Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21) |
| Balance | Functional Reach Test | Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21) |
| Lower Limb Strength | Five Times Sit to Stand Test | Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21) |
| Grip Strength | Hand-held dynamometer | Three assessment points: 1) Baseline 2) At the end of the intervention program 3) At the end of the study (week 21) |
| Range of motion of wrist extension and tibiotarsal movements | Measured with a manual goniometer | Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12. |
| Excursion of the median and fibular nerves | Measured by ultrasound | Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12. |
| Pressure Pain Threshold measured in three different sites (thenar region of the hand; dorsum of foot; region of greatest pain) | Measured with an algometer | Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12. |
| Q-sense - Cold and Warm Perception Threshold (thenar region of the hand; dorsum of foot; region of greatest pain) | It will be assessed using a portable quantitative sensory testing device capable of assessing peripheral sensory nerve function using hot and cold thermal sensory thresholds (Q-sense, Medoc). | Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12. |
| Q-sense - Heat Pain Threshold (thenar region of the hand; dorsum of foot; region of greatest pain) | It will be assessed using a portable quantitative sensory testing device capable of assessing peripheral sensory nerve function (Q-sense, Medoc). | Measured from week 1 to week 9-12 (twice a week). Considering that participants will have different baseline durations and the same intervention duration (8 weeks), the assessment of this outcome can be done up to week 9, 10, 11, or 12. |