Journal of International Academy of Physical Therapy Research (국제물리치료학회지)

International Academy of Physical Therapy Research (국제물리치료연구학회)
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Short-term Effectiveness of the Movement Direction in Neurodynamic Mobilization for Upper Limb Mobility and Pain

  • An, Hojung (Department of Physical Therapy, Dongnam Health University) ;
  • Moon, Okkon (Department of Physical Therapy, Howon University) ;
  • Choi, Junghyun (Department of Physical Therapy, Namseoul University)
  • Received : 2019.10.18
  • Accepted : 2019.11.27
  • Published : 2019.12.31
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Abstract

Background: Neurodynamic mobilization is divided into slider mobilization and tensioner mobilization. However, movement direction in neurodynamic mobilization has been overlooked in neurodynamic exercise program. Objective: To examine the effect of movement direction in neurodynamic mobilization on upper limb mobility and pain. Design: Quasi-experimental study Methods: Twenty-two adults positive for neurodynamic test for the median nerve were recruited for participation in this study. Twenty-two subjects were allocated to the applied neurodynamic mobilization at limited side group (ANTLS, n=7), the applied neurodynamic mobilization at contralateral limited side group (ANTCLS, n=7), and the applied neurodynamic mobilization at bilateral side group (ANTBS, n=8). Before the intervention upper limb limited was measured neurodynamic test for the median nerve, pain was measured using visual analogue scale (VAS), movement direction in neurodynamic mobilization was applied to each group, and then re-measured using neurodynamic test for the median nerve and VAS. Differences the Intra-groups before and between the intergroups after intervention were analyzed. Results: In the ANTLS and ANTBS groups, a statistically significant increase in ROM and decrease in VAS score in the population before and after intervention were indicated. Statistically significant differences in VAS and ROM from before to after intervention were found among the ANTLS, ANTCLS, and ANTBS groups. Conclusions: The results of the present study indicate that movement direction in neurodynamic mobilization must be considered within the limits of its selected range of the neurodynamic exercise program.

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References

  1. Ellis RF, Hing WA. Neural mobilization: a systematic review of randomized controlled trials with an analysis of therapeutic efficacy. J Man Manip Ther. 2008;16(1):8-22. https://doi.org/10.1179/106698108790818594
  2. Scrimshaw SV, Maher CG. Randomized controlled trial of neural mobilization after spinal surgery. Spine (Phila Pa 1976). 2001;26(24):2647-52. https://doi.org/10.1097/00007632-200112150-00002
  3. Basson A, Olivier B, Ellis R, et al. The effectiveness of neural mobilizations in the treatment of musculoskeletal conditions: a systematic review protocol. JBI Database System Rev Implement Rep. 2015;13(1):65-75. https://doi.org/10.11124/jbisrir-2015-1401
  4. Pederson WC. Median nerve injury and repair. J Hand Surg Am. 2014;39(6):1216-22. https://doi.org/10.1016/j.jhsa.2014.01.025
  5. Coppieters MW, Butler DS. Do 'sliders' slide and 'tensioners' tension? An analysis of neurodynamic techniques and considerations regarding their application. Man Ther. 2008;13(3):213-21. https://doi.org/10.1016/j.math.2006.12.008
  6. Akalin E, El O, Peker O, et al. Treatment of carpal tunnel syndrome with nerve and tendon gliding exercises. Am J Phys Med Rehabil. 2002;81(2):108-13. https://doi.org/10.1097/00002060-200202000-00006
  7. Sharma S, Balthillaya G, Rao R, et al. Short term effectiveness of neural sliders and neural tensioners as an adjunct to static stretching of hamstrings on knee extension angle in healthy individuals: A randomized controlled trial. Phys Ther Sport. 2016;17:30-7. https://doi.org/10.1016/j.ptsp.2015.03.003
  8. Ballestero-Perez R, Plaza-Manzano G, UrracaGesto A, et al. Effectiveness of nerve gliding exercises on carpal tunnel syndrome: A systematic review. J Manipulative Physiol Ther. 2017;40(1):50-9. https://doi.org/10.1016/j.jmpt.2016.10.004
  9. Neto T, Freitas SR, Marques M, et al. Effects of lower body quadrant neural mobilization in healthy and low back pain populations: A systematic review and meta-analysis. Musculoskelet Sci Pract. 2017;27:14-22. https://doi.org/10.1016/j.msksp.2016.11.014
  10. Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991;14:409-15.
  11. Diez Valdes S, Vega JA, Martinez-Pubil JA. Upper Limb Neurodynamic Test 1 in patients with Acquired Brain Injury: a cross-sectional study. Brain Inj. 2019;33(8):1039-44. https://doi.org/10.1080/02699052.2019.1606441
  12. Butler DS. Adverse mechanical tension in the nervous system: a model for assessment and treatment. Aust J Physiother. 1989;35(4):227-38. https://doi.org/10.1016/S0004-9514(14)60511-0
  13. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8(12):1153-7. https://doi.org/10.1111/j.1553-2712.2001.tb01132.x
  14. Beltran-Alacreu H, Jimenez-Sanz L, Fernandez Carnero J, et al. Comparison of Hypoalgesic Effects of Neural Stretching vs Neural Gliding: A Randomized Controlled Trial. J Manipulative Physiol Ther. 2015;38(9):644-52. https://doi.org/10.1016/j.jmpt.2015.09.002
  15. Bueno-Gracia E, Perez-Bellmunt A, Lopez-deCelis C, et al. Dimensional changes of the carpal tunnel and median nerve during manual mobilization of the carpal bones - Anatomical study. Clin Biomech (Bristol, Avon). 2018;59:56-61. https://doi.org/10.1016/j.clinbiomech.2018.09.001
  16. David B. The Sensitive Nervous System. South Australia: Noigroup Publications; 2000.
  17. Millesi H. The nerve gap. Theory and clinical practice. Hand Clin. 1986;2(4):651-63. https://doi.org/10.1016/S0749-0712(21)00614-4
  18. Rozmaryn LM, Dovelle S, Rothman ER, et al. Nerve and tendon gliding exercises and the conservative management of carpal tunnel syndrome. J Hand Ther. 1998;11(3):171-9. https://doi.org/10.1016/S0894-1130(98)80035-5
  19. Ekstrom RA, Holden K. Examination of and intervention for a patient with chronic lateral elbow pain with signs of nerve entrapment. Phys Ther. 2002;82(11):1077-86. https://doi.org/10.1093/ptj/82.11.1077
  20. Tal-Akabi A, Rushton A. An investigation to compare the effectiveness of carpal bone mobilisation and neurodynamic mobilisation as methods of treatment for carpal tunnel syndrome. Man Ther. 2000;5(4):214-22. https://doi.org/10.1054/math.2000.0355
  21. Maitland GD. The slump test: examination and treatment. Aust J Physiother. 1985;31(6):215-9. https://doi.org/10.1016/S0004-9514(14)60634-6
  22. Sharma S, Verma SK, Agarwal V. Effects of neural mobilization in posterior myofascial chain flexibility in normal subjects. Int J Physiother Res. 2015;3(4):1122-5. https://doi.org/10.16965/ijpr.2015.140