Effect of Nerve Mobilization in Reducing Pain in Patients with Guyon Canal Syndrome
DOI:
https://doi.org/10.26911/theijmed.2024.09.01.14Abstract
Background: Guyon Canal Syndrome is a peripheral ulnar neuropathy caused by lesions of the distal ulnar nerve, specifically in the Guyon's tunnel which is at the base of the hypothenar eminence where the ulnar nerve branches and is susceptible to compression. These tunnel structures are frequently subject to cycling-related injuries, sudden compression or repetitive vibration. Guyon Canal Syndrome causes loss of motor, sensory function, or a combination of motor and sensory function. The aim of this research is to determine the effect of nerve mobilization on reducing pain in Guyon Canal Syndrome.
Subjects and Method: This research is a quasi-experimental research conducted at the Grhasia Mental Hospital, Yogyakarta Special Region, in June-July 2023. A total sample of 8 patients diagnosed with Guyon canal syndrome was selected using purposive sampling. The sample was divided into 2 groups (1) 4 people received nerve mobilization and (2) 4 people received standard care. The dependent variable is pain. The independent variable is nerve mobilization. Pain was measured using the Quadruple Visual Analogue Scale (QVAS). The difference in pain scores before and after intervention in the two groups was tested using an independent t test.
Results: The average difference in pain score reduction in the intervention group (Mean= -11.75; SD= 5.68) was greater than the control (Mean= -3.5; SD= 11.39), but not statistically significant (p= 0.242).
Conclusion: The average difference in pain score reduction in the intervention group was greater than the control, but not statistically significant.
Keywords: Guyon canal syndrome, pain, nerve mobilization
References
Aleksenko D, Varacallo M (2018). Guyon Canal Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.-nih.gov/books/NBK431063/.
Bachoura A, Jacoby SM (2012). Ulnar Tunnel Syndrome. Orthop Clin North Am. 43(4): 467–474. doi: 10.1016/j.-ocl.2012.07.016.
Brotzman SB, Novotny SR (2018). Nerve Compression Syndromes. Clinical orthopaedic rehabilitation: a team approach (Fourth Edition). 32-41.e1. doi:10.1016/B978-0-323-39370-6.0-0007-X.
Brown CK, Stainsby B, Sovak G (2014). Guyon Canal Syndrome: lack of management in a case of unresolved handlebar palsy. J Can Chiropr Assoc. 58(4): 413-420. https://pubmed.ncbi.-nlm.nih.gov/25550666.
Ellis RF, Phty B, Dip G, Hing WA (2008). Neural mobilization: A systematic review of randomized controlled trials with an analysis
of therapeutic efficacy J Man Manip Ther. 16(1): 8-22. doi:10.1179/1066981087908185-94.
Fadel ZT, Samargandi OA, Tang DT (2017). Variations in the anatomical structures of the guyon canal. Plastic Surg. 25(2), 84–92. doi: 10.1177/229-2550317694851.
Gilbert KK, James CR, Apte G, Brown C, Sizer PS, Brismée JM, Smith MP (2015). Effects of simulated neural mobilization on fluid movement in cadaveric peripheral nerve sections: Implications for the treatment of neuropathic pain and dysfunction. J Man Manip Ther. 23(4): 219–225. doi:10.1179/2042618614Y.0000000094.
Hadders-Algra M (2018). Early human motor development: From variation to the ability to vary and adapt. Neurosci Biobehav Rev. 90: 411-427. doi:10.1016/j.neubiorev.2018.05.009.
Khadijah S, Budi IS (2020). Efektivitas Neural Mobilization Terhadap Pe-ningkatan Aktivitas Dan Kemampuan Fungsional Pada Ischialgia (Effectiveness of Neural Mobilization in Increasing Activity and Functional Ability in Ischialgia). 1(1), 6–16. doi:10.23917/jurnal.fisiomu.v1i1.-9394.
Khajeh R, Farzan M, Jamshidi SMMM, Moharrami A (2021). Guyon Canal Syndrome Due to Schwannomas of Zone 3 Ulnar Nerve without Neuro-logic Symptoms: A Case Report. Arch Bone Jt Surg. 9(5): 598–600. doi:10.22038%2Fabjs.2020.50869.2520.
Kopcik K (2023). Guyon Canal Syndrome and handlebar palsy – summary of available knowledge. J Pre-Clin Clin Res. 17(1), 23–26. doi:10.26444/-jpccr/159709.
Mateus A, Rebelo J, Silva AG (2020). Effects of a multimodal exercise program plus neural gliding on postural control, pain, and flexibility of institutionalized older adults: A randomized, parallel, and double-blind study. J Geriatr Phys Ther. 43(1): 3–11. doi: 10.1519/JPT.00000-00000000249.
Mbada C, Akindele F, Fatoye C, Ademoyegun A, Odole A, Ogunlana M, Idowu A, Adegbemigun O, Fatoye F (2021). Translation and psycho-metric evaluation of the yoruba version of quadruple visual analogue scale. Ann Ig. 33(5):443-455. doi:10.4103/njhs.njhs_4_20.
Ozdemir O, Calisaneller T, Gulsen S, Caner H (2011). Ulnar nerve entrapment in guyon’s canal due to recurrent carpal tunnel syndrome: Case report. Turk Neurosurg. 21(3): 435–437. doi:10.-5137/1019-5149.JTN.2959-10.1.
Patterson JMM, Jaggars MM, Boyer MI (2003). Ulnar and median nerve palsy in long-distance cyclists. A prospective study. Am J Sports Med. 31(4): 585-9. doi:10.1177/-03635465030310041801.
Rai G, Kamath GS, Kavirayani V, Bishnoi AK, Reddy R (2021). A rare case of hypothenar hammer syndrome triggering guyon’s canal syndrome. J Clin Diagn Res. 15(3): 7-8. doi:10.7860/jcdr/2021/46951.14658.
Shacklock M (2005). Improving application of neurodynamic (neural tension) testing and treatments: A message to researchers and clinicians. Man Ther. 10(2): 175–179. doi:10.1016/j.math.2005.03.001.
Slane J, Timmerman M, Ploeg HL, Thelen DG (2011). The influence of glove and hand position on pressure over the ulnar nerve during cycling. Clin Biomech (Bristol, Avon). 26(6):642-8. doi:10.1016/j.clinbiomech.2011.03.003.
Sudhagar G, Le Blanc M (2012). Conservative management of ulnar tunnel syndrome: secondary to excessive healing tissue; a rare complication after flexor tendon injury-a case report. Tech Hand Up Extrem Surg. 16(2):64-6. doi:10.109-7/bth.0b013e31823f06f6.
Vikranth GR, Vinod KKC, Mathias L (2015). Comparative effect of carpal bone mobilization versus neural mobilization in improving pain, functional status and symptoms severity in patients with carpal tunnel syndrome. Int J Physiother. 2(3). doi:10.15621/-ijphy/2015/v2i3/67025.
Zeeshan M, Ahmed F, Kanwal D, Khalid QSB, Ahmed MN (2009). Guyon's canal syndrome due to tortuous ulnar artery with DeQuervain stenosing tenosynovitis, ligamentous injuries and dorsal intercalated segmental instability syndrome, a rare presentation: a case report. Cases J. 2: 9390. doi:10.1186%2F1757-1626-2-9390.
