The effect of Brachial Plexus gliding on pain and upper extremity function in overhead athletes with Thoracic outlet syndrome
Oral Presentation
Paper ID : 1974-11THCONF
Authors
1گروه کاردرمانی،دانشگاه علوم بهزیستی و توانبخشی
2Department of Physical Education and Sports Sciences, Tarbiat Modares University, Tehran, Iran.
3گروه کاردیولوژی،بیمترستان بعثت
4دانشکده علوم پزشکی،معاون آموزش
Abstract
Introduction: Thoracic outlet syndrome (TOS) typically presents as upper extremity symptoms caused by compression of the neurovascular structures in the area of the neck above the first rib. Clinical manifestations can include upper extremity pain, paresthesia, numbness, weakness, fatigability, swelling, discoloration, and Raynaud phenomenon. Repetitive overhead motions and exercise exhibited by athletes may lead to loss of shoulder girdle stability. Subclavius posticus muscle is supernumerary anatomical variation of the subclavius muscle. Presenting hypertrophy of dominate arm due to their sport activity. all of which contribute to the development of True neurogenic and vascular TOS. Athletes might be at even higher risk given the relative amount of musculature developed in training. Despite bilateral subclavius posticus, TOS was only evident in dominate limb in which the association of hypertrophy of lateral cervical muscles, resulting from the overhead sport activity, to the subclavius posticus likely led to a significant reduction of the upper thoracic outlet space. Rehabilitation therapy in appropriately selected patients can provide relief of symptoms and protection from future disability. The aim of this study was to evaluate the effect of 12 weeks Brachial Plexus gliding on pain and upper extremity function in overhead athletes with Thoracic outlet syndrome.
Methodology: In this clinical trial, 14 available high-performance athletes with neurogenic Thoracic Outlet Syndrome without acute symptoms, in an average age of 20.5 ± 5.41 years were randomly selected and assigned to the intervention (n=7) and control (n=7) groups. Patient demographics, workup and treatment approaches were recorded and analyzed. Athletes with TOS were assessed with function surveys using Disabilities of Arm, Shoulder and Hand (DASH) scale, and pain with Visual Analogue Scale (VAS). Common practices of correction of posture, maximizing muscle endurance and power and stretch shorten muscles within 12 weeks for both groups were applied. The intervention group in addition was used Brachial Plexus gliding. Before intervention, after 6 and 12 weeks, function and pain of patients was evaluated. SPSS software, version 20, K2 test, independent t-test and repeated measure was used to analyze the results.
Results: There was significant difference in increase of function between the groups (p<0/05). Although in decrease of the pain between the groups was significant (p<0/005).
Discussion: Both the correction of posture and nerve gliding exercises decrease pain and improve function of overhead athletes. However, in order to improve function and decrease the pain, the nerve gliding exercise are more effective than other one.
Methodology: In this clinical trial, 14 available high-performance athletes with neurogenic Thoracic Outlet Syndrome without acute symptoms, in an average age of 20.5 ± 5.41 years were randomly selected and assigned to the intervention (n=7) and control (n=7) groups. Patient demographics, workup and treatment approaches were recorded and analyzed. Athletes with TOS were assessed with function surveys using Disabilities of Arm, Shoulder and Hand (DASH) scale, and pain with Visual Analogue Scale (VAS). Common practices of correction of posture, maximizing muscle endurance and power and stretch shorten muscles within 12 weeks for both groups were applied. The intervention group in addition was used Brachial Plexus gliding. Before intervention, after 6 and 12 weeks, function and pain of patients was evaluated. SPSS software, version 20, K2 test, independent t-test and repeated measure was used to analyze the results.
Results: There was significant difference in increase of function between the groups (p<0/05). Although in decrease of the pain between the groups was significant (p<0/005).
Discussion: Both the correction of posture and nerve gliding exercises decrease pain and improve function of overhead athletes. However, in order to improve function and decrease the pain, the nerve gliding exercise are more effective than other one.
Keywords
Thoracic outlet syndrome; Nerve gliding exercise; High-performance athletes; Pain; Subclavius posticus muscle
Subjects