Neurodynamic Testing

Question 1

what is neurodyanmic testing

Answer 1

it refers to the response of nerves and surrounding tissue to mechanical stress

Question 2

what is adverse neural tension

Answer 2

defined as an abnormal response of the neural tissue to mechanical stimuli

Question 3

neural provocation tests:

Answer 3

apply controlled mechanical stress to dura and nerve

performed in a sequential and progressive manner

using longitudinal traction force attempting to reproduce pt symptoms

perfomed as special tests towards the end of a full orthopedic evaluation

Question 4

cause of nerve dysfunction

Answer 4

scar tissue/adhesions
swelling
stretch injury (tension)
other extra neural restrictions (osteophyte, disc protrustion or prolapse)
close proximity to an unstable joint
mechanical or chemical irritants could lead to pain

Question 5

during a joint movement:

Answer 5

slack in nervous system is taken up

• whole peripheral nerve moves as adjacent connective tissue

in mid range there is maximal nerve sliding
- sliding occurs adjacent to and toward the moving jt (convergeence)

at end range tension builds as nerve sliding ends
- sliding occurs further from moving jt

when tension is release
- sliding occurs away from moving joint (divergence)

Question 6

contraindications to neural mobs

Answer 6

malignancies of NS
acute inflammatory infections
instability
SCI
CNS disorders
worsening neurologic signs and symptoms
cauda equina symptoms
suspected disc lesions
dizziness related to CAD
extreme pain

Question 7

precautions to neural tension testing

Answer 7

do not over lengthen
do not prolong
within 7 seconds or ischemia
spinal canal is 5-9cm longer in flexion than extension

Question 8

median nerve
testing

Answer 8

patient in supine
shoulder ABD to 90
full ER
elbow flexed
wrist anf fingers neutral

therapist: depress scapula, extend elbow, supinate forearm, extend wrist and thumb/fingers

to sensitize: add cervical SB away

Question 9

ulnar nerve testing

Answer 9

patient supine
shoulder ABD to 90
full ER
elbow flexed
wrist and fingers neutral

therapist: depress scapula, flex elbow, pronate forearm, extend wrist and fingers

to sensitize: add cervical SB AWAY

Question 10

radial nerve testing

Answer 10

patient arm at side

therapist: depress scapulae with hip
IR shoulder
extend elbow
pronate forearm
flex wrist and fingers
ulnarly deviate

to sensitize: add cervical SB AWAY