ROLE OF THERAPEUTIC EXERCISES IN NEUROGENIC THORACIC OUTLET SYNDROME
AbstractBackground: Neurogenic Thoracic Outlet Syndrome (TOS) is a set of signs and symptomsexisting due to compression of brachial plexus in the cervical area. We performed the study tohighlight the role of therapeutic exercises on patients with neurogenic thoracic Outlet Syndrome.Methods: This quasi-experimental study was carried out at Armed Forces Institute ofRehabilitation Medicine (AFIRM), Rawalpindi. Fifty consecutive patients of neurogenic TOS ofboth genders and all ages were selected. Patients were diagnosed clinically and the diagnosis wasconfirmed by electrodiagnosis. These patients were asked to follow a therapeutic exercisesprogram for 6 months. Outcome measures included Visual Analogue Scale (VAS) and UlnarNerve Conduction Velocity across neck. Results were compared by applying relevant tests ofsignificance on follow up visits at 3 and 6 months. Results: Mean age was 39.1±7.79 years.Thirty seven (74%) cases were females and thirteen (26%) were males. On each visit, statisticalanalysis showed significant improvement with therapeutic exercises. After 6 months ofconservative treatment, 17 (34%) of patients showed full recovery, 14 (28%) had markedimprovement, 16 (32%) had partial improvement while 3 (6%) patients reported with persistentsevere symptoms. Conclusion: Current study shows that a trial of therapeutic exercises providesrelief of symptoms of Neurogenic Thoracic Outlet Syndrome in majority of patients.Key Words: Thoracic Outlet Syndrome, entrapment syndromes, Electrodiagnosis, TherapeuticExercises, Rehabilitation
Woods WW: Personal experiences with the surgical
treatment of 250 cases of cervicobrachial neurovascular
compression syndrome. J Int Coll Surg. 1965;44:273–83.
R. A. Cooke. Thoracic outlet syndrome-aspects of diagnosis
in the differential diagnosis of hand-arm vibration syndrome,
Occup Med (Lond). 2003;53(5):331–6.
Brantigan CO, Roos DB. Diagnosing thoracic outlet
syndrome, Hand Clin, 2004;20:27–36.
England JD, Tiel RL: AAEM case report 33: costoclavicular
mass syndrome. Amr. Ass. Of Electrodiagnostic Medicine.
Muscle Nerve 1999;22:412–8.
Gruss D. Thoracic outlet syndrome. Acta Chir Aust
Tolson TD. EMG for thoracic outlet syndrome. Hand Clin
Balci AE, Balci TA, Cakiro, Eren S, Eren MN. Surgical
treatment of thoracic outlet syndrome: effects and results of
surgery. Ann Thoracic Surgery 2003;75:1091–6.
J Ayub Med Coll Abbottabad;19(4)
Niazi PHK, Ahmad K, Hussain A, Waheed A, Alam A.
Electrodiagnosis of Thoracic Outlet Syndrome. J Med Armed
Forces Pak. 2001;51(1):6–9.
Andrew KC, Bohan JS. Thoracic outlet syndrome [online]
[cited 2006 October 06]; Available form: URL:
Nancy AK. Evaluation and treatment of thoracic outlet
syndrome [online] 2003 [cited 2004 Apr 5]; Available form
URL: http://www.therasite-thoracic outlet handouts.htm
Benjamin MS: Thoracic outlet syndrome [online] 2006 [cited
December 13]; Available from URL:
Landry GJ, Moneta GL, Taylor LM Jr, Edwards JM, Porter
JM. Long-term functional outcome of neurogenic thoracic
outlet syndrome in surgically and conservatively treated
patients. J Vasc Surg 2001;33:312–7, 317–9.
Nakatsuchi Y, Saitoh S, Hosaka M, Matsuda S. Conservative
treatment of thoracic outlet syndrome using an orthosis. J
Hand Surg [Br]. 1995;20:34–9.
Buonocore M, Manstretta C, Mazzucchi G, Casale R. The
clinical evaluation of conservative treatment in patients with
the thoracic outlet syndrome. G Ital Med Lav Ergon
Tariq M, Zahir J, Saleem SA. Role of acupuncture in thoracic
outlet syndrome. BMJ Acupuncture in Med 2000;18:122–3.
Kenny RA, Traynor GB, Withington D, Keegan DJ. Thoracic
outlet syndrome: a useful exercise treatment option. Am J
Singh MK, Patel J. Thoracic outlet syndrome [online] 2006
[cited 2006 January 31]; Available from: URL:
Dubuisson AS. The thoracic outlet syndrome [online] 2002
[cited 2005 May 25]; Available from URL:
Garcia ND, Eskandari M, Tehrani H, Morasch MD. Thoracic
outlet obstruction [online] 2007 [cited 2007 May 23]; Available
from URL: http://www.emedicine.com/med/topic2774.htm.
Lindgren KA. Conservative treatment of thoracic outlet
syndrome: a 2-year follow-up. Arch Phys Med Rehabil.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.