In Situ Mechanical Effects of a Specific Neurodynamic Mobilization of the Superficial Fibular Nerve: A Cadaveric Study
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Lavoie, Félix-Antoine
St-Pierre, Marc-Olivier
Paquin, Jean-Philippe
Gilbert, Kerry K
Ellis, Richard
Sobczak, Stéphane
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The National Athletic Trainers' Association
Abstract
Context: A specific neurodynamic mobilization for the superficial fibular nerve (SFN) has been suggested in the reference literature for manual therapists to evaluate nerve mechanosensitivity in patients. However, no authors of biomechanical studies have examined the ability of this technique to produce nerve strain. Therefore, the mechanical specificity of this technique is not yet established.
Objectives: To test whether this examination and treatment technique produced nerve strain in the fresh frozen cadaver and the contribution of each motion to total longitudinal strain.
Design: Controlled laboratory study.
Setting: Laboratory.
Main outcome measure(s): A differential variable reluctance transducer was inserted in 10 SFNs from 6 fresh cadavers to measure strain during the mobilization. A specific sequence of plantar flexion, ankle inversion, straight-leg raise position, and 30° of hip adduction was applied to the lower limb. The mobilization was repeated at 0°, 30°, 60°, and 90° of the straight-leg raise position to measure the effect of hip-flexion position.
Results: Compared with a resting position, this neurodynamic mobilization produced a significant amount of strain in the SFN (7.93% ± 0.51%, P < .001). Plantar flexion (59.34% ± 25.82%) and ankle inversion (32.80% ± 21.41%) accounted for the biggest proportions of total strain during the mobilization. No difference was noted among different hip-flexion positions. Hip adduction did not significantly contribute to final strain (0.39% ± 10.42%, P > .05), although high variability among limbs existed.
Conclusions: Ankle motion should be considered the most important factor during neurodynamic assessment of the SFN for distal entrapment. These results suggest that this technique produces sufficient strain in the SFN and could therefore be evaluated in vivo for correlation with mechanosensitivity.
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Keywords
manual therapy, mechanosensitivity, nerve strain, neurodynamics, straight-leg raise, 4201 Allied Health and Rehabilitation Science, 32 Biomedical and Clinical Sciences, 3202 Clinical Sciences, 42 Health Sciences, Clinical Research, Neurodegenerative, Bioengineering, Musculoskeletal, 1106 Human Movement and Sports Sciences, Sport Sciences, 3202 Clinical sciences, 4201 Allied health and rehabilitation science, 4207 Sports science and exercise
Source
Journal of Athletic Training, ISSN: 1062-6050 (Print); 1938-162X (Online), The National Athletic Trainers' Association, 58(5), 445-451. doi: 10.4085/1062-6050-0154.22
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The Journal of Athletic Training is a publication of the National Athletic Trainers’ Association (NATA). The Journal does not charge publication fees and is fully open access and free of charge to all users.