Neurodynamic Treatment: Difference between revisions
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== Description == | == Description == | ||
Neural | Neural mobilization is a treatment modality of neurodynamics. Neurodynamic treatment falls within manipulative therapy - a group of techniques that aid in pain relief and restoration of function<ref>Vicenzino B, Collins D, Wright A. [https://www.academia.edu/3739416/The_initial_effects_of_a_cervical_spine_manipulative_physiotherapy_treatment_on_the_pain_and_dysfunction_of_lateral_epicondylalgia The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia.] Pain. 1996 Nov 1;68(1):69-74.</ref>Neural mobilization, as a treatment technique, was introduced nearly 30 years ago and comprised of 16 techniques, closely resembling neurodynamic tests. | ||
Neural mobilisation generally consists of techniques termed neural glides or neural flossing. Neural stretching is also performed as a mobilisation technique. Although glides or flossing is also seen by some as a stretch, they are generally more dynamic in nature. | Neural mobilisation generally consists of techniques termed neural glides or neural flossing. Neural stretching is also performed as a mobilisation technique. Although glides or flossing is also seen by some as a stretch, they are generally more dynamic in nature.<ref name=":0" /> | ||
=== Objectives of neural mobilisation === | === Objectives of neural mobilisation === | ||
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=== Indication === | === Indication === | ||
Various upper limb conditions including various upper limb nerve entrapment syndromes. For example: carpal tunnel syndrome, cubital tunnel syndrome and nonacute cervical radiculopathy.<ref>COPPIETERS M. Hough A. Dilley A. Different Nerve-Gliding Exercises Induce Different Magnitudes of Median Nerve Longitudinal Excursion: An In Vivo Study Using Dynamic Ultrasound Imaging. Journal of Orthopaedic and Sports Physical Therapy. 2009 [cited at 31 May 2022]. Available from: https://www.jospt.org/doi/pdf/10.2519/jospt.2009.2913</ref> | Various upper limb conditions including various upper limb nerve entrapment syndromes. For example: carpal tunnel syndrome, cubital tunnel syndrome and nonacute cervical radiculopathy.<ref name=":0">COPPIETERS M. Hough A. Dilley A. Different Nerve-Gliding Exercises Induce Different Magnitudes of Median Nerve Longitudinal Excursion: An In Vivo Study Using Dynamic Ultrasound Imaging. Journal of Orthopaedic and Sports Physical Therapy. 2009 [cited at 31 May 2022]. Available from: https://www.jospt.org/doi/pdf/10.2519/jospt.2009.2913</ref> | ||
==== Procedure ==== | ==== Procedure ==== | ||
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Description[edit | edit source]
Neural mobilization is a treatment modality of neurodynamics. Neurodynamic treatment falls within manipulative therapy - a group of techniques that aid in pain relief and restoration of function[1]Neural mobilization, as a treatment technique, was introduced nearly 30 years ago and comprised of 16 techniques, closely resembling neurodynamic tests.
Neural mobilisation generally consists of techniques termed neural glides or neural flossing. Neural stretching is also performed as a mobilisation technique. Although glides or flossing is also seen by some as a stretch, they are generally more dynamic in nature.[2]
Objectives of neural mobilisation[edit | edit source]
The main objectives of neural mobilisation are to:
- Achieve overall balance in the nervous system.
- Restore balance to the dynamic neural structures and the surrounding mechanical interfaces, by restoring the slide and glide of the nerves. This is performed through pressure relief on affected structures.[3] [4]
- Normalizing the intraneural environment (through 1. & 2.)
Median nerve glide[edit | edit source]
Indication[edit | edit source]
Various upper limb conditions including various upper limb nerve entrapment syndromes. For example: carpal tunnel syndrome, cubital tunnel syndrome and nonacute cervical radiculopathy.[2]
Procedure[edit | edit source]
Slump stretching[edit | edit source]
Indication[edit | edit source]
Most often this technique is used for individuals who suffer from lower back pain (LBP), non radicular in nature and display mild to moderate mechano sensitivity (often more distal in nature).[5]This sensitivity can be tested through the slump test and strait leg raise (SLR) test.
Procedure[edit | edit source]
Position: Patient in long sitting with feet against the wall (to ensure ankle remains at 0° dorsiflexion).
Therapist: applies over-pressure into cervical spine flexion to the point where symptoms are reproduced.
Duration: The position is held for 30 seconds.
Repetition: 5x.
As a home exercise program:[edit | edit source]
Done as a self stretch.
Position: Patient in long sitting with feet against the wall.
Patient provides own over-pressure with upper extremities until symptoms are reproduced.
Duration: The position is held for 30 seconds.
Repetition: 2x.
Resources[edit | edit source]
An article demonstrating different neural glide techniques: Different Nerve-Gliding Exercises Induce Different Magnitudes of Median Nerve Longitudinal Excursion: An In Vivo Study Using Dynamic Ultrasound Imaging
References[edit | edit source]
- ↑ Vicenzino B, Collins D, Wright A. The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain. 1996 Nov 1;68(1):69-74.
- ↑ 2.0 2.1 COPPIETERS M. Hough A. Dilley A. Different Nerve-Gliding Exercises Induce Different Magnitudes of Median Nerve Longitudinal Excursion: An In Vivo Study Using Dynamic Ultrasound Imaging. Journal of Orthopaedic and Sports Physical Therapy. 2009 [cited at 31 May 2022]. Available from: https://www.jospt.org/doi/pdf/10.2519/jospt.2009.2913
- ↑ Ellis RF, Hing WA. Neural mobilization: a systematic review of randomized controlled trials with an analysis of therapeutic efficacy. Journal of manual & manipulative therapy. 2008 Jan 1;16(1):8-22
- ↑ Russel J. Neural Manipulation: Hands-on work to promote nerve tissue health. iahe.com. Available from: https://www.iahe.com/docs/articles/261-neural-manipulation.pdf. (Accessed 31 May 2022)
- ↑ Cleland JA, Childs JD, Palmer JA, Eberhart S. Slump stretching in the management of non-radicular low back pain: a pilot clinical trial. Manual therapy. 2006 Nov 1;11(4):279-86.
