Search Results (5)

The aim of this study was to evaluate the efficacy of manual therapy based on neurodynamic techniques and electrophysical modalities in the conservative treatment of cubital tunnel syndrome (CuTS). A total of 128 upper limbs affected by CuTS were initially enrolled in this study, with 82 completing the full treatment protocol. The participants were divided into the following two intervention arms: the first arm (MT) (42 arms) received therapy based on sliding and tensioning neurodynamic techniques, while the second arm (EM) (40 arms) underwent physiotherapy based on electrophysical modalities, specifically low-level laser therapy (LLLT) and ultrasound therapy (US). Chi² and Student’s t-test were used to compare the intervention arms, and no statistically significant differences were found. The evaluated outcomes included nerve conduction testing, ultrasound assessments (measuring cross-sectional area and shear modulus), pain levels, two-point discrimination, thresholds for cutaneous sensory perception, symptom severity, functional ability in specific tasks, and overall post-treatment improvement. Baseline comparisons indicated no statistically significant differences in any measured variables between the intervention groups (p > 0.05). Following treatment, each group exhibited significant improvements in their respective parameters (p < 0.01). Comparisons between groups post-intervention revealed statistically significant differences in nerve conduction results, ultrasound measurements (cross-sectional area and shear modulus), two-point discrimination, and sensory perception thresholds. These parameters improved more in the MT intervention arm. The use of neurodynamic techniques, ultrasound, and low-level laser therapy in the conservative treatment of mild to moderate forms of CuTS has a beneficial therapeutic effect. Full article

Background: The Upper Limb Neural Tension Test (ULNTT) is a common assessment for neurodynamic function, yet the relationship between ULNTT findings and specific spinal biomechanical patterns remains poorly understood, particularly in the context of cervicobrachial neuralgia. This study aimed to investigate the association between ULNTT asymmetry and cervicothoracic spine biomechanics using advanced motion capture analysis. Methods: A longitudinal experimental study was conducted on two groups of asymptomatic participants: one with ULNTT asymmetry > 10° (AS group, n = 12) and another with symmetrical ULNTT (S group, n = 11). Neurodynamic testing and 3D motion capture of spinal kinematics during head lateral bending were performed at baseline. The AS group then underwent manual medicine intervention targeting spinal mobility impairments, followed by post-intervention reassessment. Spine biomechanics data, focusing on the C5-T4 region, were analyzed using the least squares approximation method to derive parameters describing upper thoracic (T1-T4_VERT) and lower cervical (C5-T1_CONC) lateral bending, and their interrelationship (ANGLE_TANG). Results: At baseline, the AS group showed significant differences between sides in neurodynamic parameters and T1-T4_VERT, with limited upper thoracic lateral bending contralateral to the side of the restricted ULNTT. Significant intergroup differences were also observed for these parameters. Following intervention in the AS group, significant improvements were noted in neurodynamic parameters and T1-T4_VERT, with no significant between-side differences post-intervention. Conclusions: These are preliminary results and preliminary conclusions based on the first study on a small group of patients. Given the limitations, this study provides evidence for a relationship between ULNTT asymmetry and upper thoracic spine biomechanics, specifically a contralateral limitation in lateral bending. These findings suggest a functional link between brachial plexus neurodynamics and upper thoracic spine mobility, offering potential insights into the pathophysiology of cervicobrachial conditions and highlighting the potential role of manual therapy in addressing both neurodynamic and biomechanical impairments. The developed motion capture analysis method offers a novel approach to quantify fine spinal motion patterns. Full article

Background/Objective: To assess the effectiveness of therapy based on sliding and tensioning neurodynamic techniques in the conservative treatment of mild and moderate forms of cubital tunnel syndrome (CuTS) compared to sham therapy. Methods: A single-blinded, randomized placebo-controlled trial. The study was conducted at several medical clinics. Individuals diagnosed with CuTS (initially 136 subjects, of whom 91 completed the full protocol) participated in the experiment. In the experimental group (MT), sliding and tensioning neurodynamic techniques were applied, whereas in the control group (ST), a sham therapy was used, involving the performance of neurodynamic techniques in an intermediate position without following the specific neurodynamic sequence for the ulnar nerve. The therapy was administered five times per week over the course of 10 sessions. All participants underwent assessments, including nerve conduction studies, ultrasound imaging (cross-sectional area and shear modulus), pain levels, two-point discrimination sensation, cutaneous sensory perception threshold, symptoms, ability to perform certain activities, and changes in improvement following treatment. Results: A baseline assessment revealed no significant inter-group differences in all examined parameters (p > 0.05). After therapy, there was a statistically significant intra-group improvement in all parameters tested (p < 0.01). In the MT group, the intra-group differences were significant across all parameters tested (p < 0.01). However, in the ST group (sham therapy), only the shear modulus showed statistically significant changes, while the other tested parameters remained unchanged. Conclusions: Neurodynamic techniques demonstrate superior therapeutic effects compared to sham therapy in the treatment of mild to moderate forms of CuTS. Full article

Background: Somatic nerve injuries are a rising problem leading to disability associated with neuropathic pain commonly reported as mechanical allodynia (MA) and hyperalgesia. These symptoms are strongly dependent on specific processes in the dorsal root ganglia (DRG). Neurodynamic treatment (NDT), consisting of selective uniaxial nerve repeated tension protocols, effectively reduces pain and disability in neuropathic pain patients even though the biological mechanisms remain poorly characterized. We aimed to define, both in vivo and ex vivo, how NDT could promote nerve regeneration and modulate some processes in the DRG linked to MA and hyperalgesia. Methods: We examined in Wistar rats, after unilateral median and ulnar nerve crush, the therapeutic effects of NDT and the possible protective effects of NDT administered for 10 days before the injury. We adopted an ex vivo model of DRG organotypic explant subjected to NDT to explore the selective effects on DRG cells. Results: Behavioural tests, morphological and morphometrical analyses, and gene and protein expression analyses were performed, and these tests revealed that NDT promotes nerve regeneration processes, speeds up sensory motor recovery, and modulates mechanical pain by affecting, in the DRG, the expression of TACAN, a mechanosensitive receptor shared between humans and rats responsible for MA and hyperalgesia. The ex vivo experiments have shown that NDT increases neurite regrowth and confirmed the modulation of TACAN. Conclusions: The results obtained in this study on the biological and molecular mechanisms induced by NDT will allow the exploration, in future clinical trials, of its efficacy in different conditions of neuropathic pain. Full article

Background: Lumbar radiculopathy is a nerve root disorder whose correct diagnosis is essential. The objective of the present study was to analyze the reliability diagnostic validity of eight neurodynamic and/or orthopedic tension tests using magnetic resonance imaging as the Gold Standard. Methods: An epidemiological study of randomized consecutive cases which was observational, descriptive, transversal, double blinded and was conducted following the Standards for Reporting Diagnostic accuracy studies (STARD) declaration. The sample size was 864 participants. Internal and external validity (CI = 95%) and reliability, were calculated for all tests performed independently. The diagnostic validity of the combined and multiple tests in parallel was also calculated. Results: The analysis indicated that only two tests performed independently had external validity, but neither had reliability or precision. The Straight Leg Raise test and the Bragard test performed in a multiple parallel way showed high sensitivity (97.40%), high negative predictive value (PV− 96.64%) and external validity (Likelihood Ratio− 0.05). The combined test of the Slump test and the Dejerine’s triad had internal and external validity. Conclusions: The Straight Leg Raise test and the Bragard test performed in a multiple parallel way and the combined test of the Slump Test and the Dejerine’s triad have clinical validity to discard lumbar or lumbar-sacral radiculopathy. Full article