title: Repeatability and Minimal Detectable Change in Longitudinal Median Nerve Excursion Measures During Upper Limb Neurodynamic Techniques in a Mixed Population: A Pilot Study Using Musculoskeletal Ultrasound Imaging.
abstract: This study determined test-retest reliability and minimum detectable change in longitudinal median nerve excursion during upper limb neurodynamic tests (ULNTs). Seven participants with unilateral or bilateral carpal tunnel syndrome and 11 healthy participants were randomly tested with two ULNTs (i.e., tensioner and slider). Each ULNT was performed three times each at 45° and 90° of shoulder abduction on two separate visits. Video sequences of median nerve excursion, recorded by a physical therapist using ultrasound imaging, were quantified using computer software. The generalizability theory, encompassing a G-Study and a D-study, measured the dependability coefficient (Φ) along with standard error of measurement (SEM) accuracy and allowed various testing protocols to be proposed. The highest reliability (Φ = 0.84) and lowest minimal measurement error (SEM = 0.58 mm) of the longitudinal median nerve excursion were reached during the ULNT-slider performed with 45° of shoulder abduction and when measures obtained from three different image sequences recorded during a single visit were averaged. It is recommended that longitudinal median nerve excursion measures computed from three separate image sequences recorded during a single visit be averaged in clinical practice. Ideally, adding a second visit (six image sequences) is also suggested in research protocols.
authors: Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal-Institut de réadaptation Gingras-Lindsay-de-Montréal, Montreal, Quebec, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
authors: Philippe
authors: P
authors: Paquette
authors: Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal-Institut de réadaptation Gingras-Lindsay-de-Montréal, Montreal, Quebec, Canada; Department of Physical Medicine and Rehabilitation, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
authors: Martin
authors: M
authors: Lamontagne
authors: Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal-Institut de réadaptation Gingras-Lindsay-de-Montréal, Montreal, Quebec, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
authors: Johanne
authors: J
authors: Higgins
authors: Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal-Institut de réadaptation Gingras-Lindsay-de-Montréal, Montreal, Quebec, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Electronic address: dany.gagnon.2@umontreal.ca.
authors: Dany H
authors: DH
authors: Gagnon
mesh_terms: D000328:Adult; D000465:Algorithms; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008875:Middle Aged; D009068:Movement; D010808:Physical Examination / Q000379:methods; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
keywords: Carpal tunnel syndrome; Median nerve; Neurodynamics; Reliability; Ultrasound