Do 'sliders' slide and 'tensioners' tension? An analysis of neurodynamic techniques and considerations regarding their application.

Abstract:

:Despite the high prevalence of carpal tunnel syndrome and cubital tunnel syndrome, the quality of clinical practice guidelines is poor and non-invasive treatment modalities are often poorly documented. The aim of this cadaveric biomechanical study was to measure longitudinal excursion and strain in the median and ulnar nerve at the wrist and proximal to the elbow during different types of nerve gliding exercises. The results confirmed the clinical assumption that 'sliding techniques' result in a substantially larger excursion of the nerve than 'tensioning techniques' (e.g., median nerve at the wrist: 12.6 versus 6.1mm, ulnar nerve at the elbow: 8.3 versus 3.8mm), and that this larger excursion is associated with a much smaller change in strain (e.g., median nerve at the wrist: 0.8% (sliding) versus 6.8% (tensioning)). The findings demonstrate that different types of nerve gliding exercises have largely different mechanical effects on the peripheral nervous system. Hence different types of techniques should not be regarded as part of a homogenous group of exercises as they may influence neuropathological processes differently. The findings of this study and a discussion of possible beneficial effects of nerve gliding exercises on neuropathological processes may assist the clinician in selecting more appropriate nerve gliding exercises in the conservative and post-operative management of common neuropathies.

journal_name

Man Ther

journal_title

Manual therapy

authors

Coppieters MW,Butler DS

doi

10.1016/j.math.2006.12.008

subject

Has Abstract

pub_date

2008-06-01 00:00:00

pages

213-21

issue

3

eissn

1356-689X

issn

1532-2769

pii

S1356-689X(07)00034-3

journal_volume

13

pub_type

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