About this trial
This randomized controlled trial will investigate whether adding neurodynamic tensioning to a grip strengthening program provides additional improvements in hand grip strength in healthy adults. Sixty participants aged 18 to 40 years will be randomly assigned to two groups. Both groups will perform a standardized grip strengthening program for six weeks, three days per week. The experimental group will additionally receive neurodynamic tensioning exercises targeting the median and ulnar nerves. Hand grip strength will be assessed at baseline, week 3, and week 6. The study aims to determine whether neurodynamic tensioning provides additional benefit beyond grip strengthening alone.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Aged between 18 and 40 years.
Willing to participate voluntarily in the study.
No history of upper-extremity pain, injury, or surgery within the previous three months.
No diagnosed neurological, rheumatological, or systemic disease affecting the peripheral nervous system.
Disqualifiers
History of carpal tunnel syndrome, cervical radiculopathy, peripheral neuropathy, or upper-extremity entrapment neuropathy.
History of upper-extremity fracture or surgery within the previous six months.
Regular participation in grip strengthening exercises or intensive upper-extremity resistance training.
Use of medication that may affect neuromuscular performance.
Trial design
Parallel
Treatments tested in this trial
Grip Strengthening Program
Other interventionParticipants will perform a standardized grip strengthening program using an adjustable hand gripper with the dominant hand for six weeks, three sessions per week. Each session will consist of 3 sets of 8-12 repetitions, with approximately 2 seconds of gripping and 2 seconds of relaxation per repetition. Rest periods of 60-90 seconds will be provided between sets. Resistance will be progressively adjusted according to performance and perceived exertion.
Neurodynamic Tensioning
Other interventionNeurodynamic tensioning targeting the median and ulnar nerves will be applied before the grip strengthening program. For each nerve, 3 sets of 10 repetitions will be performed, with each repetition consisting of approximately 4-5 seconds of controlled rhythmic tensioning. A 30-second rest period will be provided between sets. The technique will be performed within pain-free limits, producing only a mild stretching sensation.
Treatment groups
Trial outcomes
Primary outcomes
Change in Hand Grip Strength
Hand grip strength of the dominant hand will be measured in kilograms (kg) using a Jamar hand dynamometer or an equivalent valid and reliable hand dynamometer. Measurements will be performed in three upper-extremity positions: standard seated position with the elbow at 90 degrees of flexion, elbow extension with the shoulder in a neutral position, and shoulder at 90 degrees of flexion with the elbow extended. Three trials will be performed in each position, and the mean of the three measurements will be used for analysis.
Secondary outcomes
Change in Pinch Strength
Pinch strength will be assessed using a pinch gauge, if available, including lateral and/or palmar pinch measurements. Measurements will be performed on the dominant hand, and changes over time will be compared between groups.
Change in Manual Dexterity
Manual dexterity will be assessed using the Nine-Hole Peg Test or an equivalent valid and reliable manual dexterity test. Performance will be recorded at each assessment time point, and changes over time will be compared between groups.
Perceived Exertion During the Intervention
Perceived exertion during the grip strengthening exercises will be recorded using a rating of perceived exertion (RPE). RPE will be used to monitor exercise intensity and guide progression of resistance throughout the intervention.
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