Improving the radial nerve neurodynamic test: An observation of tension of the radial, median and ulnar nerves during upper limb positioning

Journal article


Manvell, Joshua J., Manvell, Nicole, Snodgrass, Suzanne J. and Reid, Susan Anne. (2015) Improving the radial nerve neurodynamic test: An observation of tension of the radial, median and ulnar nerves during upper limb positioning. Manual Therapy. 20(6), pp. 790 - 796. https://doi.org/10.1016/j.math.2015.03.007
AuthorsManvell, Joshua J., Manvell, Nicole, Snodgrass, Suzanne J. and Reid, Susan Anne
Abstract

The radial nerve neurodynamic test (ULNT2b), used to implicate symptoms arising from the radial nerve, is proposed to selectively increase strain of the nerve without increasing strain of adjacent tissue, though this has not been established. This study aimed to determine the upper limb position that results in: (1) the greatest tension of the radial nerve and (2) the greatest difference in tension between the radial nerve and the other two major nerves of the upper limb: median and ulnar. Tension (N) of the radial, median and ulnar nerves was measured simultaneously using three buckle force transducers during seven upper limb positions in the axilla of ten embalmed whole body human cadavers (n = 20 limbs). Repeated measures analysis of variance (ANOVA) with Bonferroni post-hoc tests determined differences in tension between nerves and between limb positions. A Composite position consisting of ULNT2b (scapular depression, shoulder internal rotation, elbow extension, forearm pronation, wrist flexion) with the addition of shoulder abduction 40° and extension 25°, wrist ulnar deviation and thumb flexion demonstrated significantly greater tension of the radial nerve than any other tested position (mean tension 11.32N; 95% CI 10.25, 12.29, p < 0.01), including ULNT2b (2.20N; 1.84, 2.57; p < 0.01). Additionally, the Composite position demonstrated the greatest difference in tension between the radial and median (mean difference 4.88N; 95% CI 3.16, 6.61; p < 0.01) and radial and ulnar nerves (9.26N, 7.54, 10.99; p < 0.01). This position constitutes a biomechanically plausible test to detect neuropathic pain related to the radial nerve.

Keywordsbrachial plexus; mechanical stress; peripheral nervous system diseases
Year2015
JournalManual Therapy
Journal citation20 (6), pp. 790 - 796
PublisherChurchill Livingstone
ISSN1356-689X
Digital Object Identifier (DOI)https://doi.org/10.1016/j.math.2015.03.007
Scopus EID2-s2.0-84951573914
Page range790 - 796
Research GroupSchool of Allied Health
Place of publicationUnited Kingdom
Permalink -

https://acuresearchbank.acu.edu.au/item/887z1/improving-the-radial-nerve-neurodynamic-test-an-observation-of-tension-of-the-radial-median-and-ulnar-nerves-during-upper-limb-positioning

Restricted files

Publisher's version

  • 7
    total views
  • 0
    total downloads
  • 1
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Physical characteristics associated with neck pain and injury in rugby union players
Snodgrass, Suzanne J., Osmotherly, Peter G., Reid, Susan A., Milburn, Peter D. and Rivett, Darren A.. (2018) Physical characteristics associated with neck pain and injury in rugby union players. The Journal of Sports Medicine and Physical Fitness. 58(10), pp. 1474 - 1481. https://doi.org/10.23736/S0022-4707.17.07255-3
Tension of the ulnar, median, and radial nerves during ulnar nerve neurodynamic testing : Observational cadaveric study
Manvell, Nicole, Manvell, Joshua, Snodgrass, Suzanne and Reid, Susan. (2015) Tension of the ulnar, median, and radial nerves during ulnar nerve neurodynamic testing : Observational cadaveric study. Physical Therapy. 95(6), pp. 891 - 900. https://doi.org/10.2522/ptj.20130536
Effects of Cervical Spine Manual Therapy on Range of Motion, Head Repositioning and Balance in Participants with Cervicogenic Dizziness : A Randomized Controlled Trial
Reid, Susan, Callister, Robin, , Katekar, Michael and Rivett, Darren. (2014) Effects of Cervical Spine Manual Therapy on Range of Motion, Head Repositioning and Balance in Participants with Cervicogenic Dizziness : A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation. 95(9), pp. 1603 - 1612. https://doi.org/10.1016/j.apmr.2014.04.009
Comparison of Mulligan sustained natural apophyseal glides and Maitland mobilizations for treatment of cervicogenic dizziness : A randomized controlled trial
Reid, Susan, Rivett, Darren, Katekar, Michael and Callister, Robin. (2014) Comparison of Mulligan sustained natural apophyseal glides and Maitland mobilizations for treatment of cervicogenic dizziness : A randomized controlled trial. Physical Therapy. 94(4), pp. 466 - 476. https://doi.org/10.2522/ptj.20120483
Children with cerebral palsy and periventricular white matter injury : Does gestational age affect functional outcome?
Harvey, Adrienne, Randall, Melinda, Reid, Susan, Lee, Katherine, Imms, Christine, Rodda, Jillian, Eldridge, Beverley, Orsini, Francesca and Reddihough, Dinah. (2013) Children with cerebral palsy and periventricular white matter injury : Does gestational age affect functional outcome? Research in Developmental Disabilities. https://doi.org/10.1016/j.ridd.2013.05.030
Reliable classification of functional profiles and movement disorders of children with cerebral palsy
Randall, Melinda, Harvey, Adrienne, Imms, Christine, Reid, Susan, Lee, Katherine and Reddihough, Dinah. (2013) Reliable classification of functional profiles and movement disorders of children with cerebral palsy. Physical & Occupational Therapy in Pediatrics. 33(3), pp. 342 - 352. https://doi.org/10.3109/01942638.2012.747584
Efficacy of manual therapy treatments for people with cervicogenic dizziness and pain: protocol of a randomised controlled trial
Reid, Susan, Rivett, Darren, Katekar, Michael and Callister, Robin. (2012) Efficacy of manual therapy treatments for people with cervicogenic dizziness and pain: protocol of a randomised controlled trial. BMC Musculoskeletal Disorders. 13(201), pp. 1 - 8. https://doi.org/10.1186/1471-2474-13-201
A comparison of motor imagery performance in children with spastic hemiplegia and developmental coordination disorder
Williams, Jacqueline Louise, Anderson, Vicki, Reddihough, Dinah, Reid, Susan, Vijayakumar, Nandita and Wilson, Peter Henry. (2011) A comparison of motor imagery performance in children with spastic hemiplegia and developmental coordination disorder. Journal of Clinical and Experimental Neuropsychology. 33(3), pp. 273 - 282. https://doi.org/10.1080/13803395.2010.509714
Repeat Botulinum Toxin-A in the Upper Limb of Children with Hemiplegia : A Randomized Controlled Trial
Olesch, Christine, Greaves, Susan, Imms, Christine, Reid, Susan and Kerr, Graham. (2010) Repeat Botulinum Toxin-A in the Upper Limb of Children with Hemiplegia : A Randomized Controlled Trial. Developmental Medicine and Child Neurology. 52(1), pp. 79 - 86. https://doi.org/10.1111/j.1469-8749.2009.03387.x
Sustained natural apophyseal glides (SNAGs) are an effective treatment for cervicogenic dizziness
Reid, Susan A., Rivett, Darren A., Katekar, Michael G. and Callister, Robin. (2008) Sustained natural apophyseal glides (SNAGs) are an effective treatment for cervicogenic dizziness. Manual Therapy. 13(4), pp. 357 - 366. https://doi.org/10.1016/j.math.2007.03.006