title: Effects of simulated neural mobilization on fluid movement in cadaveric peripheral nerve sections: implications for the treatment of neuropathic pain and dysfunction.
abstract: OBJECTIVE
  Neural mobilization techniques are used clinically to treat neuropathic pain and dysfunction. While selected studies report efficacy of these techniques, the mechanisms of benefit are speculative. The purpose of this study was to evaluate the effects of in vitro simulated stretch/relax neural mobilization cycles on fluid dispersion within sections of unembalmed cadaveric peripheral nerve tissue.
  
  
  METHODS
  Bilateral sciatic nerve sections were harvested from six cadavers. Matched pairs of nerve sections were secured in a tissue tester and injected with a plasma/Toluidine Blue dye solution. Once the initial dye spread stabilized, the experimental nerve sections underwent 25 stretch/relaxation cycles (e.g. simulated neural mobilization) produced by a mechanical tissue tester. Post-test dye spread measurements were compared to pre-test measurements as well as control findings (no simulated mobilization). Data were analyzed using paired t-tests.
  
  
  RESULTS
  Individual dye spread measurements were reliable [ICC(3,1) = 0·99]. The post-test intraneural fluid movement (dye spread) in the experimental section increased significantly with simulated neural mobilization compared to pre-test measurements (3·2±2·1 mm; P = 0·015) and control measurements (3·3±2·7 mm; P = 0·013).
  
  
  CONCLUSIONS
  Repetitive simulated neural mobilization, incorporating stretch/relax cycles, of excised cadaveric peripheral nerve tissue produced an increase in intraneural fluid dispersion. Neural mobilization may alter nerve tissue environment, promoting improved function and nerve health, by dispersing tissue fluid and diminishing intraneural swelling and/or pressure.
authors.affiliation: Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
authors.forename: Kerry K
authors.initials: KK
authors.lastname: Gilbert
authors.affiliation: Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
authors.forename: C
authors.initials: C
authors.lastname: Roger James
authors.affiliation: Atlas Physical and Hand Therapy Eugene, OR, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Apte
authors.affiliation: Ardor Health Solutions Coral Springs, FL, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Brown
authors.affiliation: Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
authors.forename: Phillip S
authors.initials: PS
authors.lastname: Sizer
authors.affiliation: Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Brismée
authors.affiliation: Albany Medical CollegeAlbany, NY, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Smith
keywords: Entrapment; Intraneural edema; Nerve injury; Neuropathy