Effects of neural mobilizations through movement representation techniques for the improvement of neural mechanosensitivity of the median nerve region: a randomized controlled trial

Abstract

Purpose

The main objective was to compare the effects of neural mobilization (NM), NM performed through mirror therapy (MT), NM performed through action observation (AO) training and finally classic rehabilitation program (mobility and strength) exercises on neural mechanosensitivity, widespread of proximal and distal pain and pressure pain thresholds (PPT). The second objective was to assess the effects of these interventions on handgrip strength, conditioned pain modulation, motor imagery ability and temporal summation.

Materials and methods

Single-blinded randomized controlled trial. Fifty-four healthy subjects were randomly assigned to each group. Neural mechanosensitivity, widespread pain and PPT were the main variables. The secondary variables included handgrip strength, conditioned pain modulation, motor imagery ability and temporal summation.

Results

All groups showed significant differences in time*factor for neural mechanosensitivity (p = 0.001), PPT in the dermatome of the median nerve (p = 0.007), PPT at carpal tunnel (p < 0.05) and proximal widespread (p = 0.01). No differences were found for distal widespread, conditioned pain modulation, handgrip strength motor imagery ability or temporal summation (p > 0.05). There is an absence of statistically significant differences between groups.

Conclusions

NM through movement representation techniques can reduce mechanosensitivity and mechanical hyperalgesia in the median nerve dermatome and forearm, although no differences were found between groups.

Keywords:

• Movement representation techniques
• therapeutic exercise
• mechanosensitivity
• median nerve
• neurodynamic mobilization
• pressure pain threshold

Acknowledgements

We thank the Universidad Rey Juan Carlos for its supporting this investigation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

The trial was approved by the ethics committee of the Rey Juan Carlos University (2703201906919) and subsequently registered in clinicaltrial.gov (NCT04086563).