Influence of Tensioner’s Mobilization on the Centralization of Symptoms in Cervicobrachial Pain Syndrome: A Randomized Controlled Trial

Abstract

This study was designed as a randomized controlled trial. Purpose: The present study aimed to determine the impact of neural mobilization by tensioner's technique (NMTT) on the centralization of symptoms and pain in patients with cervicobrachial pain syndrome (CBPS). Overview of Literature: CBPS is a disabling condition of the neck that is characterized by pain and paresthesia in the upper quarter. Several techniques have successfully provided immediate and long-term relief in CBPS; however, few studies have evaluated the effect of these techniques on the centralization of symptoms. Methods: Thirty patients aged 18-45 years with a complaint of pain in the neck that had persisted for 2-12 weeks radiating to the arm and fulfilling Elvey's criteria were randomly selected and divided into two groups. Group A received NMTT plus conventional treatment (hot pack and postural advice with cervical lateral glide), and group B received only conventional treatment 3 times a week for 2 weeks. The outcome measures were Wernicke's scale score for the centralization of symptoms and Visual Analog Scale score for pain intensity. Within-and between-group comparisons were made before initiating treatment and at the end of the 3rd and 6th sessions. Within group analyses for the centralization values were performed using Friedmann test, and between-group analyses were performed using Mann-Whitney test. A 2×3 mixed model of the analysis of variance was used for analyzing the pain levels. Results: There was a significant difference (p<0.05) within and between the groups for both the measures at the end of the 3rd and 6th sessions. Thus, NMTT may be beneficial in decreasing the peripheralization of symptoms and pain intensity in patients with CBPS. Conclusions: NMTT can be used as an alternative and effective treatment option for patients with CBPS.

Effectiveness of neural mobilisation for the treatment of nerve-related cervicobrachial pain: a systematic review with subgroup meta-analysis

“…Neural mobilisation interventions included the following: a cervical lateral glide 16,42,67 ; upper limb sliders, 7,28,43,52,61,62,70,74,77 tensioners, 2,4,36,37,42,53 or sliders and tensioners 1,59,65,66 ; and cervical lateral glide and sliders 54 or tensioners 85 ; in 6 studies, the type of NM used was unclear. 5,22,44,60,64,84 Most often, NM was passive, 2,5,7,16,36,37,41–43,54,55,59–62,66–70,74,77,84,85 and in a minority of cases active, 54 active or passive, 4,44 or both active and passive 28,65 ; it was unclear in 4 studies. 1,5,22,64 In the majority of cases, NM was performed without symptom reproduction 2,16,54,59,66,68,72,75 ; some reported performing it without or with minimal symptoms, 1,28,42,44,53 and 2 studies at the point of symptom reproduction 4,85 ; tailoring was unclear in 14 studies.…”

Response to: Influence of Tensioner’s Mobilization on the Centralization of Symptoms in Cervicobrachial Pain Syndrome: A Randomized Controlled Trial

“…In the CONSORT for abstract given by Hopewell et al [3,4], it is clearly mentioned blinding is a part of methods and not study design. Randomization and blinding are clearly mentioned on page 121 of our paper [1].…”

“…We thank the editor for sending the letter and the researcher who found a special interest in our paper published in the esteemed Asian Spine Journal [ 1 ]. We have tried to answer the queries to the best of our knowledge.…”

“…We want to correct the researcher for the query that “the blinding is not mentioned in study design section.” In the CONSORT for abstract given by Hopewell et al [ 3 , 4 ], it is clearly mentioned blinding is a part of methods and not study design. Randomization and blinding are clearly mentioned on page 121 of our paper [ 1 ].…”

Letter to the Editor: Influence of Tensioner’s Mobilization on the Centralization of Symptoms in Cervicobrachial Pain Syndrome: A Randomized Controlled Trial

“…To start with, I would like to congratulate the authors of the published original article titled, “Influence of tensioner’s mobilization on the centralization of symptoms in cervicobrachial pain syndrome: a randomized controlled trial” in your prestige Journal “Asian Spine Journal” by Sudhakar et al [ 1 ]. We have read the article with great interest but also some points need clarification as mentioned below:…”