In Situ Mechanical Effects of a Specific Neurodynamic Mobilization of the Superficial Fibular Nerve: A Cadaveric Study

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 biomechanical studies examined the ability of this technique to produce nerve strain. Therefore, mechanical specificity of this technique is not yet established.

OBJECTIVE: The aim of our study was to test whether this examination and treatment technique was producing nerve strain in the fresh frozen cadaver and the contribution of each motion to total longitudinal strain.

DESIGN: Quantitative original research, controlled laboratory study.

METHODS: A differential variable reluctance transducer was inserted in ten SFN from six fresh cadavers to measure strain during the mobilization. A specific sequence of plantar flexion (PF), ankle inversion (INV), straight leg raise (SLR) position and 30{degree sign} of hip adduction (ADD) was applied to the lower limb. The mobilization was repeated at 0°, 30°, 60° and 90° of Straight Leg Raise (SLR) position to measure the impact of hip flexion position.

FINDINGS: Compared to a resting position, this neurodynamic mobilization produced a significant amount of strain in the SFN (7.93% ± 0.51 P < 0.001). PF (59.34% ± 25.82) and INV (32.80% ± 21.41) accounted for the biggest proportion of total strain during the mobilization. No significant difference was reported between different hip flexion positions. Hip ADD did not significantly contribute to final strain (0.39% ± 10.42 P> 0,05) although high subject variability exists.

CONCLUSION: Ankle motions should be considered the most important 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.