Median nerve stiffness with three movement sequences of the upper limb neurodynamic test 1: An ultrasound shear-wave elastography study

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice Pub Date : 2024-11-18 DOI:10.1016/j.msksp.2024.103221

Gianluca Ciuffreda , Elena Estébanez-de-Miguel , Isabel Albarova-Corral , Miguel Malo-Urriés , Michael Shacklock , Alberto Montaner-Cuello , Elena Bueno-Gracia

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引用次数: 0

Abstract

Background

During the Upper Limb Neurodynamic Test 1 (ULNT1) joint movement order can be varied to improve its diagnostic accuracy. However, nerve behavior with neurodynamic sequences still requires in vivo research.

Objective

To quantify differences in median nerve (MN) stiffness measuring shear-wave velocity (SWV) with ultrasound elastography during three sequences of the ULNT1.

Design

Cross-sectional study.

Methods

MN SWV was measured in 35 asymptomatic subjects at the wrist and elbow at the initial and final position (P1) of the standard (ULNT1-STD), proximal-to-distal (ULNT1-PROX) and distal-to-proximal (ULNT1-DIST) sequences of the ULNT1.

Results

Significantly different increases at P1 in nerve stiffness occurred between sequences and locations (p < 0.001). At the wrist, the ULNT1-PROX produced the smallest increase (44.32% ± 44.06, SWV: 4.49 ± 0.95 m/s), the ULNT1-STD produced a larger increase (82.13% ± 45.36, SWV: 5.67 ± 0.79 m/s, p < 0.001) and the ULNT1-DIST produced the largest (92.90% ± 55.37, SWV: 5.97 ± 0.79 m/s, p < 0.001). Differences between the ULNT1-DIST and ULNT1-STD did not reach significance.

At the elbow, the ULNT1-PROX showed a 119.92% ± 53.51 increase (SWV: 4.08 ± 0.84 m/s), the ULNT1-DIST a 134.84% ± 53.83 (SWV: 4.34 ± 0.77 m/s), and the ULNT1-STD a 113.30% ± 59.28 (SWV: 3.98 ± 1.04 m/s). No significant differences were found among the sequences.

Conclusion

The ULNT1-STD and ULNT1-DIST showed greater increases at MN stiffness at the wrist compared to the ULNT1-PROX. This supports a basis for future investigation of the mechanisms of neurodynamic testing in which emphasizing anatomical locations for improving diagnostic efficacy might be applied.

查看原文本刊更多论文

上肢神经动力测试 1 的三个运动序列的正中神经僵硬度：超声剪切波弹性成像研究。

背景：在上肢神经动力测试 1（ULNT1）中，可以改变关节运动顺序来提高诊断准确性。然而，神经动力学序列的神经行为仍需进行活体研究：通过超声弹性成像测量剪切波速度（SWV），量化正中神经（MN）硬度在 ULNT1 三个序列中的差异：设计：横断面研究：对 35 名无症状的受试者在 ULNT1 的标准序列 (ULNT1-STD)、近端到远端序列 (ULNT1-PROX) 和远端到近端序列 (ULNT1-DIST) 的初始和最终位置 (P1) 的手腕和肘部测量 MN SWV：结果：不同序列和位置在 P1 处神经僵硬度的增加有显著差异（p 结论：ULNT1-STD 和 ULNT1-DIST 序列在 P1 处神经僵硬度的增加有显著差异：与 ULNT1-PROX 相比，ULNT1-STD 和 ULNT1-DIST 在腕部显示出更大的 MN 硬度增加。这为今后研究神经动力测试的机制奠定了基础，在此基础上可应用解剖位置来提高诊断效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Musculoskeletal Science and Practice Health Professions-Physical Therapy, Sports Therapy and Rehabilitation

CiteScore

4.10

自引率

8.70%

发文量

152

审稿时长

48 days

期刊介绍： Musculoskeletal Science & Practice, international journal of musculoskeletal physiotherapy, is a peer-reviewed international journal (previously Manual Therapy), publishing high quality original research, review and Masterclass articles that contribute to improving the clinical understanding of appropriate care processes for musculoskeletal disorders. The journal publishes articles that influence or add to the body of evidence on diagnostic and therapeutic processes, patient centered care, guidelines for musculoskeletal therapeutics and theoretical models that support developments in assessment, diagnosis, clinical reasoning and interventions.