The effectiveness of neural mobilization of brachial plexus in patients with chronic unilateral cervical radiculopathy: A single-blinded randomized clinical trial

Neural tissue mobilization techniques are passive or active movements aiming for restoring the ability of the nervous system to tolerate the normal compressive, friction and tensile forces associated with daily activities. The effectiveness of neural mobilization (NM) for neuromuscular conditions still unclear and limited evidence. To determine the efficacy of tensioning neural mobilization (NM) on handgrip strength and pain intensity in patients with unilateral chronic cervical radiculopathy. The study was conducted at outpatient clinic in AL-Badrashin and AL-Nozha central hospitals, Cairo, Egypt. A single-blinded randomized trial. Forty participants with chronic unilateral CR were randomly assigned either to group-A (conventional physical therapy group, n =20), that received a conventional physical therapy in the form of manual traction, stretching exercise and infra-red irradiation, and group-B (neural mobilization group, n = 20) that received conventional physical therapy in addition to tensioning neural mobilization of brachial plexus. Handgrip strength and neck and arm pain were evaluated at baseline and at the end of a 3-week program. Paired and unpaired t-test, Wilcoxon singed rank test and Wilcoxon rank sum test (Mann-Whitney) were used to analyze data. There were significant within-group differences in both groups regarding both hand grip strength and pain intensity; for hand grip strength, for group (A): (P-value =0.001), and for group (B): (P-value=0.001). Regarding pain, P-value is less than (0.01) for group (A), and P-value is less than (0.01) for group (B). There was no statistically significant difference between both groups regarding both hand grip strength (p-value: 0.374), and pain intensity (p-value: 0.838).The addition of tensioning neural mobilization to conventional physical therapy yielded no significant additional benefits, although both groups showed post-treatment increased handgrip strength and decreased pain intensity.