Impact of order of movement on nerve strain and longitudinal excursion: a biomechanical study with implications for neurodynamic test sequencing.
It is assumed that strain in a nerve segment at the end of a neurodynamic test will be greatest if the joint nearest that nerve segment is moved first in the neurodynamic test sequence. To test this assumption, the main movements of the median nerve biased neurodynamic test were applied in three different sequences to seven fresh-frozen human cadavers. Strain and longitudinal excursion were measured in the median nerve at the distal forearm. Strain and relative position of the nerve at the end of a test did not differ between sequences. The nerve was subjected to higher levels of strain for a longer duration during the sequence where wrist extension occurred first. The pattern of excursion was different for each sequence. The results highlight that order of movement does not affect strain or relative position of the nerve at the end of a test when joints are moved through comparable ranges of motion. When used clinically, different neurodynamic sequences may still change the mechanical load applied to a nerve segment. Changes in load may occur because certain sequences apply increased levels of strain to the nerve for a longer time period, or because sequences differ in ranges of joint motions.
Nee
Robert J
RJ
Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, QLD 4072, Brisbane, Australia.
Yang
Chich-Haung
CH
Liang
Chung-Chao
CC
Tseng
Guo-Fang
GF
Coppieters
Michel W
MW
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001132:Arm / Q000502:physiology*; D053587:Arthrometry, Articular; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000502:physiology*; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D015203:Reproducibility of Results; D014159:Transducers