Protocol summary
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Study aim
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Compare the effectiveness of ultra-sound guided injections of corticosteroid and perineural dextrose 5% on clinical appearance, function, sonographic and electrodiagnostic findings in patients with cubital tunnel syndrome
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Design
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The research is a randomized double blind clinical trial on 22 patients.
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Settings and conduct
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Samples are selected from patients with mild to moderate ulnar neuropathy referred to physical medicine and rehabilitation clinics under supervision of shiraz university of medical sciences divided into two groups. Block Randomization Assignment and Double blind methods are used. After obtaining informed consent, In group A corticosteroid is injected under guide of ultrasound and in group B ultrasound guided prineural injection of dextrose 5% is done. Finally effects on clinical appearance, function, sonographic and electrodiagnostic findings are measured.
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Participants/Inclusion and exclusion criteria
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Inclusion criteria: Patients with age ranged from 20-65 years with diagnosis of mild to moderate ulnar neuropathy. The symptoms and signs persisted for at least 1 month.
Exclusion criteria: Patients who are in a severe condition (paresis and muscle atrophy) and have brachial plexus neuropathy, history of elbow trauma or operation, rheumatologic disorder, peripheral neuropathy such as diabetes, previous perineural injection, malignancy, coagulopathy, pregnancy, active infection, or infection of injection site.
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Intervention groups
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Group A will receive locally 1 ml Methyl Prednisolone Acetate 40 mg and 1 ml Normal saline plus 1 ml Lidocaine 2%, under guide of ultrasound, in the cubital tunnel.
Group B will receive locally 2 ml D5W plus 1 ml Lidocaine 2% ,under guide of ultrasound, in cubital tunnel.
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Main outcome variables
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Pain, Sensory and motor symptoms, Activity of daily living, Cross sectional area of ulnar nerve
General information
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Reason for update
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There was an error in recording the date of sample collection and in calculating the dates for patient examinations and preparing the necessary conditions to start the work. The correct dates for the intervention and sampling occurred after registration in the IRCT.
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Acronym
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IRCT registration information
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IRCT registration number:
IRCT20220929056056N1
Registration date:
2022-12-26, 1401/10/05
Registration timing:
prospective
Last update:
2025-01-19, 1403/10/30
Update count:
1
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Registration date
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2022-12-26, 1401/10/05
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Registrant information
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Recruitment status
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Recruitment complete
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Funding source
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Expected recruitment start date
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2023-01-20, 1401/10/30
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Expected recruitment end date
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2023-08-21, 1402/05/30
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Actual recruitment start date
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empty
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Actual recruitment end date
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empty
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Trial completion date
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empty
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Scientific title
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Comparative effectiveness of ultra-sound guided injections of corticosteroid and perineural dextrose 5% on clinical appearance, function, sonographic and electrodiagnostic findings in patients with cubital tunnel syndrome, a clinical trial study
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Public title
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Comparative effectiveness of ultra-sound guided injections of corticosteroid and perineural dextrose 5% in patients with cubital tunnel syndrome
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Purpose
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Treatment
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Inclusion/Exclusion criteria
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Inclusion criteria:
Mild to moderate ulnar nerve entrapment
Age of 20-65 years
At least 1 month persistence of symptoms and signs
Exclusion criteria:
Severe condition
Brachial plexus neuropathy
History of elbow trauma or operation
Rheumatologic disorder
Peripheral neuropathy
Previous perineural injection
Malignancy
Coagulopathy
Pregnancy
Active infection or infection of injection site
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Age
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From 20 years old to 65 years old
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Gender
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Both
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Phase
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2
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Groups that have been masked
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- Care provider
- Outcome assessor
- Data analyser
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Sample size
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Target sample size:
22
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Randomization (investigator's opinion)
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Randomized
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Randomization description
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Patients will be randomly allocated in to two groups by Block Randomization Assignment and Double blind methods. We will have two lists of 11 patients, including the two intervention and control groups, at random. For concealment, method of random sequencing is given to another person who is unaware of the research process, and the questionnaires are completed by a person unaware of the division of groups.
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Blinding (investigator's opinion)
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Double blinded
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Blinding description
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Participant: in this study, we does not have the ability to blind the participant because the participant is aware of receiving each intervention. Clinical care giver: we teach the caregiver how to complete the questionnaire. This person is not aware of receiving patient’s intervention. Researcher: this study does not have the ability to blind the researcher due to performing both interventions by himself and being aware of receiving the kind of intervention in each group. The outcome assessor of the complete questionnaires is given to a person who is not aware of the intervention performed and he/she is asked to determine the level of performance in each person according to the questionnaires. Data analyzer: questionnaire are finally given to a person to review the information. This person does not know any of the steps of the work and the way of classification in which the intervention performed.
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Placebo
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Not used
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Assignment
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Parallel
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Other design features
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Ethics committees
1
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Ethics committee
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Approval date
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2022-09-19, 1401/06/28
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Ethics committee reference number
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IR.SUMS.MED.REC.1401.318
Health conditions studied
1
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Description of health condition studied
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Cubital tunnel syndrome
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ICD-10 code
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G56.20
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ICD-10 code description
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Lesion of ulnar nerve, unspecified upper limb
Primary outcomes
1
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Description
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Upper limb pain
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Timepoint
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Before intervention, three weeks and twelve weeks later
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Method of measurement
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Visual Analogue Scale, PRUNE questionnaire
2
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Description
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Sensory and Motor symptoms
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Timepoint
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Before intervention, three weeks and twelve weeks later
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Method of measurement
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PRUNE questionnaire
Secondary outcomes
1
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Description
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Function of patient
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Timepoint
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Before intervention, three weeks and twelve weeks later
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Method of measurement
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PRUNE questionnaire
2
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Description
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cross-sectional area of ulnar nerve
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Timepoint
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Before intervention and twelve weeks later
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Method of measurement
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Ultrasonography
Intervention groups
1
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Description
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First Intervention group: The patients will be placed in a supine position with the shoulder abducted and the elbow flexed at 90°.The ulnar nerve within the cubital tunnel will be identified in transverse plane, and the injection will be conducted after aseptic preparation. Patients will receive locally 1 ml Methyl Prednisolone Acetate 40 mg and 1 ml Normal saline plus 1 ml Lidocaine 2%, in one session. The patients have to complete the Visual Analog Scale and PRUNE questionnaires before entering the study and 3 and 12 weeks after intervention. Electrodiagnostic and sonographic findings will be evaluated before intervention and 12 weeks later.
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Category
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Rehabilitation
2
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Description
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Second Intervention group: The patients will be placed in a supine position with the shoulder abducted and the elbow flexed at 90°.The ulnar nerve within the cubital tunnel will be identified in transverse plane, and the injection will be conducted after aseptic preparation. Patients will receive locally 2 ml D5W plus 1 ml Lidocaine 2%, in one session. The patients have to complete the Visual Analog Scale and PRUNE questionnaires before entering the study and 3 and 12 weeks after intervention. Electrodiagnostic and sonographic findings will be evaluated before intervention and 12 weeks later.
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Category
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Rehabilitation
1
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Sponsor
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Grant name
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Grant code / Reference number
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Is the source of funding the same sponsor organization/entity?
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No
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Title of funding source
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Shiraz University of Medical Sciences
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Proportion provided by this source
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100
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Public or private sector
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Public
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Domestic or foreign origin
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Domestic
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Category of foreign source of funding
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empty
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Country of origin
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Type of organization providing the funding
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Academic
Sharing plan
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Deidentified Individual Participant Data Set (IPD)
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Yes - There is a plan to make this available
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Study Protocol
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Yes - There is a plan to make this available
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Statistical Analysis Plan
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Yes - There is a plan to make this available
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Informed Consent Form
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Yes - There is a plan to make this available
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Clinical Study Report
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Yes - There is a plan to make this available
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Analytic Code
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Yes - There is a plan to make this available
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Data Dictionary
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Yes - There is a plan to make this available
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Title and more details about the data/document
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All available data can be shared after making people unidentifiable.
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When the data will become available and for how long
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Start access period one year after publishing the results.
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To whom data/document is available
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Everyone can access to this information.
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Under which criteria data/document could be used
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If the information in this study helps to improve the science process.
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From where data/document is obtainable
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Dr. Maryam Mirhadi, 00989177398937, maryam.mirhadii@gmail.com
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What processes are involved for a request to access data/document
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After sending the desired message, all authors of the study will be consulted all information will be sent within a maximum of three weeks if permitted.
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Comments
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