Purpose: We investigated how nerve mobilization influence ankle plantar flexor muscles of the affected lower extremity on the spasticity in stroke patients. Method: Total 12 patients were recruited, who had spasticity on ankle of the affected lower extremity, and applied nerve mobilization on the sciatic and tibial nerves in supine position. H-reflex was measured using EMG equipment, detected the ratio of maximum H/M and H-reflex latency, and compared the changes before, during, right after, 5 minutes after and 10 minutes after the application of nerve mobilization. The data were analyzed using repeated measure ANOVA to compare the changes in length of time. Results: In comparison with the ratio before nerve mobilization, the ratio of maximum H/M was significantly decreased during nerve mobilization(p<0.05), and it tended toward recovery right after, 5 minutes after and 10 minutes after applying nerve mobilization, there was no statistically significant difference(p>0.05). In comparison with the ratio before nerve mobilization, the ratio of maximum H/M was most significantly decreased during the first 10 seconds after nerve mobilization and it tended toward recovery gradually(p<0.05). In comparison with the H-reflex latency before nerve mobilization, it was significantly increased during nerve mobilization(p<0.05) and it was decreased right after nerve mobilization, After 5 and 10 minutes, it had a tendency toward recovery but it revealed no statistically significant difference (p>0.05). Conclusion: It is considered that nerve mobilization could contribute to initial rehabilitation with stroke patients for relieving spasticity and nerve contracture.
Journal of International Academy of Physical Therapy Research
/
v.8
no.1
/
pp.1105-1113
/
2017
The Purpose of this study was to determine the effects of sciatic nerve mobilization on pain and lower back muscle strength in female patients in their 40s who have been diagnosed with lumbar radiculopathy. Using a simple blinded method, 20 female patients with neuropathy in the nerve segments between L4-S1 were randomly divided into one group (n=10) that would undergo sciatic nerve mobilization, and another group (n=10) that would perform lower back segment stabilization exercises. The two groups attended 3 sessions per week, with each session taking 30 minutes, for a duration of 4 weeks. In the preliminary examinations, the pain index as well as the isometric muscle strength of the lower back extensor and flexor muscles were measured. After the passing of 4 weeks. The same method of measurement was used for the concluding examinations. Comparison of the pain indices in the two groups revealed that they both experienced a statistically significant decrease, and further inspection revealed that the there was a more substantial difference in the sciatic nerve mobilization group. Results of comparing changes in the Isometric Muscle Strength lower back muscle and bending muscle by group, In comparison between groups, the isometric strength of the lower back extensor showed a more significant difference in the sciatic nerve mobilization group (p <.05). Conclulsion, it can be inferred that application of sciatic nerve mobilization has a positive effect on the pain index and isometric muscle strength of the lower back in female patients with lumbar radiculopathy in their 40s.
Kang, Jeong IL;Moon, Young Jun;Jeong, Dae Keun;Choi, Hyun;Park, Joon Su;Choi, Hyun Ho
Journal of International Academy of Physical Therapy Research
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v.9
no.2
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pp.1447-1454
/
2018
The objective of this study was to investigate the dynamic neural mobilization program on the changes in muscle activity and nerve conduction velocity (NVC) in stroke patients. The participants were sampled and randomly divided into experimental group I (n=12) who underwent arm neural mobilization and experimental group II (n=13) who underwent arm dynamic neural mobilization. As the pretest, peripheral NVC of the radial, median, and ulnar nerves were measured using the Viking Quest; the biceps brachii, brachioradialis, flexor carpi radialis, and extensor carpi radialis activities were measured with sEMG. Each intervention program consisted of 10 trials per set and three sets per session. The intervention programs were performed once daily for four weeks (four days/week). Posttest measurements were taken equally as the pretest measurements. Significant differences in peripheral NVC in all sections of the radial and median nerves and wristbelow elbow and below elbow-above elbow areas of the ulnar nerve, as well as in muscle activity of all muscles except the biceps brachii. These findings indicate that dynamic neural mobilization was effective in increasing peripheral NVC and altering the muscle activity.
The purpose of this study was to evaluate the effects of mobilization of the sciatic nerve on hamstring flexibility, lower limb strength, and gait performance in patients with chronic stroke. This study was a randomized clinical trial with a crossover design. Sixteen subjects were recruited for this study. The subjects were randomly divided into two intervention groups and underwent either of the following two interventions: sciatic nerve mobilization or static stretching of the hamstring. We assessed hamstring flexibility, lower limb strength, and gait performance using a digital inclinometer, a hand-held dynamometer, and the 10-meter walk test, respectively. Subjects had a 24-hour rest period between each session in order to minimize carryover effects. Measurements for each test were assessed prior to and immediately after the intervention sessions. Using a two-way analysis of variance test with repeated measures, data from the two trials were analyzed by comparing the differences between both techniques. The level of statistical significance was set at .05. Sciatic nerve mobilization resulted in significantly better knee extensor strength (p=.023, from $15.32{\pm}5.98$ to $18.16{\pm}6.95kg$) and knee flexor strength (p=.011, from $7.80{\pm}4.80$ to $8.15{\pm}4.24kg$) in the experimental group than in the control group. However, no significant effects of static stretching of the hamstring were observed on hamstring flexibility from the ankle plantar flexion (p=.966) and ankle neutral positions (p=.210) and on gait performance (p=.396). This study indicated that the sciatic nerve mobilization technique may be more effective in muscle activation of the knee extensor muscle and knee flexor muscle than hamstring static stretching technique in patients with chronic stroke.
Journal of the Korean Society of Physical Medicine
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v.4
no.2
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pp.107-115
/
2009
Purpose:This study was to determine whether median nerve mobilization has any effect on the recovery of muscle power and the reduction of pain for the patients with carpal tunnel syndrome. Methods:20 patients suffering from carpal tunnel syndrome were randomly divided into two groups: 10 subjects treated both with electrical therapy and median nerve mobilization(experimental group) and the other 10 subjects treated only with electrical therapy(control group). The therapy was taken three times a week for 3 weeks. Results:The grip strength increased in both groups. However, the experimental group showed more significant treatment effect than the control group, and the significant changes appeared every week during the experiment period. In terms of pain, both groups showed significant effects. But the experimental group showed but more significant treatment effect than the control group, and the significant changes appeared every week during the experiment period. Conclusions:It was significantly more effective for the patients with carpal tunnel syndrome to apply median nerve mobilization during the electrical therapy in order to reduce pain and to increase grip strength, compared with the method only using electrical therapy. Further research should be conducted to generalize these results in terms of the clinical effectiveness of the nerve mobilization.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.20
no.2
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pp.27-34
/
2014
Background: This study examined the effects of cervical traction group and cervical traction & nerve mobilization exercise group after applying conservative physical therapy to Computer Workers with Cervical Radiculopathy. Methods: They were randomly divided into two groups: 18 subjects were cervical traction group, 22 subjects were cervical traction and nerve mobilization exercise group. Each group performed its own exercise 30 minutes per day, three times per week, for 4 weeks. Pain intensity was measured by the visual analogue scale (VAS) and neck disability index (NDI). Cervical extensor muscles strength (CEMS) was measured by the Pressure biofeedback unit. Grasping power (GP) was measured by the Grip Track Commander. Results: After 4 weeks therapy, VAS and NDI were significantly reduced in both groups (p<.05) and CEMS and GP were significantly increased in both groups (p<.05). Significant differences were also evident between the two groups for these three measurements (p<.05). Conclusions: cervical traction and nerve mobilization exercise group is more effective than cervical traction group for reducing VAS and NDI and increasing GP in computer workers with cervical radiculopathy.
Journal of International Academy of Physical Therapy Research
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v.10
no.4
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pp.1921-1925
/
2019
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.
The purpose of this study was to determine the effect of sciatic nerve mobilization technique on perceived pain, straight leg raise test (SLR), and strength of knee extensor, location of symptoms (LOS) in patients with chronic low back pain. 22 patients with chronic low back pain were recruited for this study. The subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with 11 patients in each group. All patients received a routine physical therapy (hot pack and transcutaneous electrical nerve stimulation). The mobilization technique of the sciatic nerve was performed for 10 min in the case of the EG subjects. Outcome measurements included the level of the perceived pain, SLR, and strength of the knee extensor, LOS. The measurements were recorded 3 times: before the intervention, after the intervention, and at 1 hour of follow up. The two groups did not significantly differ with regard to the level of perceived pain, SLR, and strength of the knee extensor, LOS before the test (p>.05). In the case of the EG subjects, all the variables measured after the intervention significantly differed from those measured before the intervention (p<.05). However, in the case of the CG subjects, a significant difference was noted only with regard to the level of perceived pain (p<.05). The findings indicate that sciatic nerve mobilization technique exerts a positive effect on the control of subjective symptoms and knee strength in patients with chronic low back pain. Further studies are required to generalize the result of this study.
The purpose of this study was to examine the acute effects of nerve mobilization, static stretching, and hold-relax on the flexibility of hamstring muscles and their surface electromyographic (EMG) responses to passive stretches in poststroke hemiparesis. This study was a randomized cross-over trial. Fourteen subjects received three treatment sessions in random order with each consisting of ten repetitions. The treatment sessions included nerve mobilization, static stretching, and hold-relax. The treatment sessions were held at least 24 hours apart to minimize any carryover effect. The outcome was measured by the distance between the greater trochanter and lateral malleolus and hamstring EMG activity during passive knee extension stretching. Repeated-measures analysis of variance showed significant changes in hamstring flexibility and EMG activity in main effect of time pre, post and followup (p<.05). However, no significant differences occurred among the three stretching techniques. No technique was consistently found to be superior. The three stretching techniques in this study make it difficult to determine the most effective technique. Therefore, clinicians use nerve mobilization of effective stretching techniques with other stretching techniques.
Journal of the Korean Society of Physical Medicine
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v.12
no.4
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pp.11-18
/
2017
PURPOSE: The purpose of this study was to examine the effects of sciatic nerve mobilization techniques on straight leg raising (SLR) and walking ability in elderly women aged over 65. METHODS: Seventy women aged over 65 were examined using SLR test and forty women were selected as subjects. They were divided into Group I (under $70^{\circ}$ of SLR test of both legs, n=20) and Group II (over $70^{\circ}$ of SLR test of both legs, n=20). Nerve mobilization was applied to both groups (three times a week for 4 weeks). SLR angle was measured using digital goniometer and walking ability was measured by step length, stride length, velocity, double support, using GAITRite System. After 4 weeks, paired t-test was used to compare the changes of SLR test and walking ability within Group I and Group II. RESULTS: In Group I, SLR test, step length, stride length and gait velocity were significantly increased but double support was significantly difference. In Group II, SLR test, step length and stride length were significantly increased but gait velocity was not significantly increased and double support was significantly decreased. CONCLUSION: This study showed that sciatic nerve mobilization techniques had positive effects on the SLR angle and walking ability in elderly women.
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