Study of the normal response to the upper limb neurodynamic test 2b and 1 in asymptomatic violin and viola players.

Abstract

Background: Professional musicians exhibit a high prevalence of work-related musculoskeletal disorders, with nerve entrapment syndromes and dysfunctions of the peripheral nervous system accounting for a significant proportion of these issues. The radial and median nerves of the upper limb are among the most commonly injured nerves due to mechanical and repetitive work. The upper limb neurodynamic test for the radial nerve (ULNT2b) and the upper limb neurodynamic test for the median nerve (ULNT1) are two of the most frequently used tests to assess the mechanosensitivity of these nerves. Currently, there are no studies that describe the normal responses in populations of violinists and violists.

Purpose: Study of the normal response to the ULNT2b and ULNT1 in asymptomatic violin and viola players.

Study design: A prospective epidemiological study of consecutive cases was designed, characterized as observational, descriptive, comparative, cross-sectional, and double-blind, following the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

Methods: The normal responses of the ULNT2b and ULNT1 tests were reported in violin and viola musicians. The range of motion (ROM) in degrees was recorded with structural differentiation, along with the location and characteristics of the reported symptom.

Results: The total sample consisted of 56 cases (n=56). In the ULNT2b, the mean range of motion (ROM) was 10.1° ± 16.2, with the most prevalent symptoms being tightness in the dorsal aspect of the forearm. In the ULNT1, the mean ROM was 115.4° ± 39.4, with tightness in the palmar aspect of the forearm being the most commonly reported symptom.

Conclusions: Asymptomatic viola and violin players exhibit greater mechanosensitivity in the radial and median nerves during the ULNT2b and ULNT1 compared to an asymptomatic population. Furthermore, there are no significant differences in the responses of both tests concerning ROM, affected areas, or symptoms, regardless of sex, instrument, or side.