COMPARATIVE EFFICACY OF SOFT TISSUE MOBILIZATION AND ULNAR NERVE–SPECIFIC STRENGTHENING EXERCISES IN PATIENTS WITH CUBITAL TUNNEL SYNDROME

Abstract

Background: Cubital tunnel syndrome is the second most common upper limb entrapment neuropathy and is characterized by pain, sensory disturbances, and functional impairment resulting from compression of the ulnar nerve at the elbow. Conservative physiotherapy is recommended for patients with mild to moderate disease; however, evidence comparing combined rehabilitation approaches with manual therapy alone remains limited.

Objective: To compare the efficacy of soft tissue mobilization combined with ulnar nerve specific strengthening exercises versus soft tissue mobilization alone in patients with mild to moderate cubital tunnel syndrome.

Methodology: A study design used in this research is a double blinded randomized control trial which was carried out on 56 participants of cubital tunnel syndrome with mild to moderate severity level chosen from two Physiotherapy clinics in Lahore, Pakistan. Random allocation of participants took place and two equal groups were created. Group A was treated with soft tissue mobilization and ulnar nerve specific exercises while Group B was treated with soft tissue mobilization only. Three treatments were carried out each week for 4 weeks. The pain intensity, upper limb disability and health-related quality of life were measured through Numeric Pain Rating Scale (NPRS) and Disabilities of the Arm.

Results: Both groups demonstrated statistically significant improvements in pain, disability, and quality of life after four weeks (p < 0.001). However, Group A achieved significantly greater improvements than Group B. At week four, NPRS scores were 2.95 ± 1.21 versus 4.94 ± 0.92 and DASH scores were 27.58 ± 8.57 versus 39.64 ± 6.68 (all p < 0.001).

Conclusion: However, both treatment methods effectively helped to enhance pain and improve the function of upper limbs of the patients suffering from cubital tunnel syndrome. However, when using the method of soft tissue mobilization in conjunction with ulnar nerve specific strengthening exercises proved to yield better results than only soft tissue mobilization.