Effect of neural mobilization of musculocutaneous nerve on spasticity of elbow flexors in post-stroke patients: a pilot study

Adelin Preety Yesudhas Shanthi; V. Balchandar

doi:10.18203/2320-6012.ijrms20263512

Authors

Adelin Preety Yesudhas Shanthi Department of Neurological Sciences, Jaya College of Physiotherapy, Jaya College of Paramedical Sciences, C.T.H. Road, Thiruninravur, Chennai, Tamil Nadu, India
V. Balchandar Jaya College of Physiotherapy, Jaya College of Paramedical Sciences, C.T.H. Road, Thiruninravur, Chennai, Tamil Nadu, India https://orcid.org/0009-0002-7181-1778

DOI:

https://doi.org/10.18203/2320-6012.ijrms20263512

Keywords:

Stroke rehabilitation, Spasticity, Musculocutaneous nerve, Neural mobilization, Surface electromyography, Range of motion

Abstract

Background: While neural mobilization shows promise, its effect on the musculocutaneous nerve remains underexplored. This pilot study evaluated the clinical effectiveness of musculocutaneous nerve mobilization on elbow flexor spasticity in chronic post-stroke individuals.

Methods: Eighteen chronic stroke survivors with elbow flexor spasticity were randomly assigned to Group A (experimental, n=9) or Group B (control, n=9). Group A received musculocutaneous nerve mobilization plus concurrent physiotherapy; Group B received structured elbow flexor stretching plus concurrent physiotherapy. Both interventions were delivered 5 times weekly for 6 weeks (45 minutes/ session). Outcome measures included surface electromyography (sEMG) root mean square difference (RMSD) of the biceps and brachialis, the Modified Ashworth Scale (MAS), and goniometric range of motion (ROM) for elbow flexion and extension lags.

Results: Both groups demonstrated statistically significant within-group improvements across all clinical and objective metrics (p<0.05 for MAS; p<0.001 for sEMG and ROM). Between-group analyses did not reach statistical significance for any outcome measure (p>0.05). However, Group A demonstrated a distinct clinical trend toward superior outcomes, achieving greater mean reductions in Biceps sEMG (7.57 μV to 4.80 μV vs. Group B: 8.36 μV to 6.68 μV) and greater decreases in flexion (15.22)^∘ with 15.22° and (7.33)^∘ with 7.33°.

Conclusion: Musculocutaneous nerve mobilization is a safe, clinically valuable intervention for post-stroke elbow spasticity. Though between-group statistical significance was limited by the pilot sample size, the technique showed superior descriptive clinical trends compared to stretching.

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