Upper Limb Neurodynamic Test of the Radial Nerve: A Study of Responses in Symptomatic and Asymptomatic Subjects
published online 29 June 2009.
Abstract
Study Design
Clinical measurement.
Introduction
Nonspecific cervical pain is a common clinical presentation. The role of upper limb neurodynamic tests (ULNT), for evaluation and treatment intervention, is not well defined for this population.
Purpose of the Study
This study's purpose was to determine if the radial-biased (RB)-ULNT discriminates any response differences between symptomatic subjects with a positive (+) RB-ULNT (n=36), symptomatic subjects with a negative (−) RB-ULNT (n=24), and asymptomatic subjects (n=60).
Methods
Sixty asymptomatic and 60 subjects presenting with nonspecific cervical and/or unilateral upper extremity pain were compared using the RB-ULNT. Symptomatic subjects were further divided in (+) and (−) RB-ULNT groups due to their response to the RB-ULNT. Within the symptomatic population, a positive response to the RB-ULNT was defined by the symptomatic subject reporting their sensations were increased with contralateral cervical lateral flexion and decreased with ipsilateral cervical lateral flexion. Sensation provocation and location were evaluated using the RB-ULNT in all the subjects during each stage of the testing.
Results
Significant differences on stage of reproduction and type of sensations were identified between 1) the (+) RB-ULNT symptomatic subjects, 2) the (−) RB-ULNT symptomatic subjects, and 3) the asymptomatic subjects. The (+) RB-ULNT group showed significantly increased pain responses during the first stage of the RB-ULNT compared with the (−) RB-ULNT group and the asymptomatic subjects. The (+) RB-ULNT also showed significantly decreased glenohumeral abduction passive range of motion when compared with the asymptomatic group.
Conclusion
Clinically, the differences found between the groups in their response to the RB-ULNT suggest heightened mechanosensitivity in the (+) RB-ULNT group.
Correspondence and reprint requests to Cheryl M. Petersen, PT, DPT, DHS, Concordia University Wisconsin, 12800 North Lake Shore Drive, Mequon, WI 53097
All the authors contributed equally to this work.
A portion of the study was conducted as a research requirement while Mr. Przechera was a master of physical therapy student in the Department of Physical Therapy and Human Movement Sciences, Northwestern University Medical School. Ms. Julian and Ms. Coderre were students in the Department of Physical Therapy and Human Movement Sciences, Northwestern University Medical School, at the time when a portion of the study was conducted, as part of the DPT requirement. All students were supervised by Ms. Petersen. This study was approved by the Northwestern University Institutional Review Board. A portion of the study was funded by a grant by the Orthopaedic Section, APTA, Inc. This article was adapted from a presentation at the Combined Sections Meeting, American Physical Therapy Association, Tampa, FL in February 2003.
Competing interests: The authors declare that they have no competing interests.
ABSTRACT