Effectiveness of Median Nerve Mobilization on Hand Grip Strength, Pinch Strength and Motor Nerve Conduction Velocity Among College Students with Smartphone Overuse
Description
Excessive smartphone uses and repetitive hand activities among young adults may contribute to early median nerve dysfunction, reduced hand strength, and altered nerve conduction parameters. Median nerve mobilization techniques are commonly used in physiotherapy to improve neural mobility, muscular performance, and functional hand ability. The current investigation sought to assess and contrast the efficacy of median nerve mobilization on grip strength, pinch strength and nerve conduction velocity among participants using HHD, Pinch Meter and NCV as outcome measures. The 36 participants in the study were split equally between Group A (the experimental group) and Group B (the control group). The study's findings demonstrated that both groups considerably improved following the intervention., suggesting that both treatment regimens were successful in enhancing neuromuscular and functional performance. A randomized trial was conducted on 36 participants who were equally allocated into Group A (Experimental Group) and Group B (Control Group) using block randomization. For four weeks, Group A received Median nerve mobilization and convention treatment, and Group B received only conventional treatment. Outcome measures included Hand Held Dynamometer (HHD) for grip strength, Pinch Meter for pinch strength, and Nerve Conduction Velocity (NCV) for electrophysiological assessment. Pre- and post-intervention assessments were performed for both groups. Data were analyzed using SPSS v25 software. Normality was tested using Shapiro wilk test. Statistical analysis was conducted using parametric and non-parametric tests based on the distribution characteristics of the data. Effect size, post hoc power analysis, and Minimal Clinically Important Difference (MCID) were also calculated. Following the interventions, both groups exhibited within-group improvement intervention in grip strength, pinch strength, and nerve conduction velocity (p < 0.05). The between-group analysis revealed statistically significant difference for HHD, Pinch Meter and NCV outcomes, indicating effectiveness of both interventions for improving muscular strength hand function and neural conduction, with the experimental group demonstrating comparatively greater improvement than the control group. The observed improvements exceeded the calculated MCID values, indicating clinically meaningful improvement. Based on the results of the study, both intervention protocols were effective in improving hand strength and neural function among smartphone-overusing college students. However, the experimental intervention demonstrated superior improvement compared to the control intervention. Therefore, the experimental intervention may be considered an effective therapeutic approach for enhancing neuromuscular performance and functional outcomes. The study supports the clinical usefulness of these rehabilitation approaches in enhancing neuromuscular performance and functional outcomes.
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Intervention Participants were divided into two groups: EG and CG. EG was treated with nerve sliding and tensioning techniques and CG was be treated with conventional exercises. The treatment was given for consecutive four weeks Sessions were conducted three times per week, each lasting 15 minutes, for a total of 12 sessions. 3.16.1 Intervention for the experimental group (EG) Patients lie supine with the shoulder abducted to 90°, externally rotated, elbow extended, forearm supinated, wrist, fingers, and thumb extended, and the head positioned for cervical lateral flexion away from the treated arm.96 Weeks 1–2, nerve sliding involves alternating wrist/finger extension with cervical side flexion to promote median nerve excursion, performed rhythmically for 2 sets of 10–15 pain-free repetitions. In weeks 3–4, nerve tensioning aims to improve nerve compliance, with cervical lateral flexion maintained and end-range stretch applied at the wrist and fingers for 2 sets of 8–10 repetitions, holding 3–5 seconds per repetition, and discontinued if symptoms worsen. 3.16.2 Intervention for the control group (CG) Stretching Exercises - (Performed 1–2 times daily; each stretch was held for 15–20 seconds and repeated 2–3 times.) • Wrist flexor stretches: Arm straight, palm facing upward, and gently pull fingers downward/backward using the opposite hand. • Wrist extensor stretches: Arm straight, palm facing downward, gently pull fingers inward/downward. • Thumb stretch: The thumb was gently pulled backward away from the palm. • Forearm pronation/supination stretch: Participants slowly rotated the forearm from palm-up to palm-down position while maintaining elbow flexion at 90°. Strengthening Exercises - (Performed 3–4 times per week, 8–12 repetitions for 2–3 sets.) • Grip strengthening: Participants squeezed soft ball/therapy putty and maintained contraction for 3–5 seconds. • Pinch strengthening: Participants pinched therapy putty/soft ball between thumb and fingers. • Wrist curls (flexion and extension): Performed using light weights (0.5–1 kg dumbbells/water bottles)
Institutions
- Maharishi Markandeshwar University, MullanaHaryana, Ambāla