تأثير تمرين هاي كششي و موبيليزاسيون عصب در بهبود درد و عملكرد اندام فوقاني در افراد با سندرم خروجي قفسه سينه

The effect of stretching and nerve mobilization exercises on improvement of pain and upper extremity function in subjects with thoracic outlet syndrome

Background and Aim: Treatment of thoracic outlet syndrome is a challenging problem for the physiotherapists and the conservative approach preferred for treatment. The purpose of this study was to determine and to compare the effects of stretching and nerve mobilization exercises on pain intensity and upper extremity functions in patients with thoracic outlet syndrome. Materials and Methods: For this double-blind, randomized controlled trail, 20 patients with thoracic outlet syndrome aging 34.95±12.9 years were recruited from zahedan physiotherapy clinics. The patients were randomly assigned to either a stretching (n=10) or a nerve mobilization groups (n=10). Before and after three weeks treatment, shoulder range of motion (degree), pain intensity (ordinal), two point discrimination (mm) and shoulder function (ordinal) were measured using goniometer, visual pain scale, caliper and shoulder pain and disability index, respectively. Independent and paired T-tests were used for comparisons between and within groups, respectively. Results: The mean of shoulder pain and disability index decreased from 92.3±9.6 to 40.5±13.9 in the stretching exercises group and from 81.0±16.3 to 25.0±12.6 in the nerve mobilization group (p<0.05). After treatment, the mean of shoulder pain and disability index decrement was greater in the nerve mobilization group than the stretching one (p<0.05). The mean range of motion of shoulder increased in both groups (p<0.05). However, no significant difference was seen between two groups in measures of shoulder joint range of motion, pain intensity and two point discrimination (p>0.05). Conclusion: Both the stretching and nerve mobilization exercises decrease pain intensity and improve hand two point discrimination, shoulder function and joint ranges of motion. However, in order to improve shoulder function, the nerve mobilization exercises are more effective than other one.