Neurodynamic Mobilization in the Conservative Treatment of Cubital Tunnel Syndrome: Long-Term Follow-Up of 7 Cases

• Published in: Journal of manipulative and physiological therapeutics 2010-02, Vol.33 (2), p.156-163
• Main Authors: Oskay, Deran, PT, PhD, Meriç, Aydın, PT, PhD, Kirdi, Nuray, PT, PhD, Firat, Tüzün, PT, PhD, Ayhan, Çiğdem, PT, MSc, Leblebicioğlu, Gürsel, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arm - physiopathology; Cubital Tunnel Syndrome; Cubital Tunnel Syndrome - physiopathology; Cubital Tunnel Syndrome - therapy; Disability Evaluation; Follow-Up Studies; Hand - physiopathology; Hand Strength; Humans; Middle Aged; Muscle Strength Dynamometer; Musculoskeletal Manipulations; Pain - physiopathology; Physical Medicine and Rehabilitation; Physical Therapy Modalities; Rehabilitation; Severity of Illness Index; Shoulder - physiopathology; Treatment Outcome; Ulnar Nerve
• ISSN: 0161-4754; 1532-6586
• DOI: 10.1016/j.jmpt.2009.12.001

Abstract Objective The aim of this case series is to describe the effect of nerve mobilization techniques in the standard conservative management of cubital tunnel syndrome (CTS). Methods Seven patients with CTS participated in this study. Inclusion criteria were having grade 1 and grade 2 entrapment neuropathy according to the McGowan grading system and no other neuropathies. In the evaluation, gripping with grip dynamometer; palmar gripping with a pinchmeter; pain level and Tinel sign with visual analog scale; sensibility with Semmes-Weinstein monofilaments; and functional status of the patients with the Turkish version of the Disability of Arm, Shoulder, and Hand Index were performed before starting a rehabilitation program, at the end of the 8-week rehabilitation program, and at 12-month follow-up. The physiotherapy program consisted of cold application, pulsed ultrasound, nerve mobilization techniques, strengthening exercises, postural adaptations, patient education, and ergonomic modifications. Results Pain; Tinel sign; and Disability of Arm, Shoulder, and Hand Index scores were decreased, whereas grip and pinch strength increased in the observation period for these 7 patients. Conclusion This case series demonstrated that conservative treatment of CTS may be beneficial for selected patients with mild to moderate symptoms. The treatment included neurodynamic mobilizations, including sliding techniques and tensioning techniques, which are thought to enhance ulnar nerve gliding and restore neural tissue mobility. Conservative treatment using neurodynamic mobilization with patient education and activity modification demonstrated some long-term positive results.