Neurodynamics Lab Flashcards
Normal Response
Tingling sensation in leg, foot, toes
Deep stretch or ache
Positive Test
Reproduces comparable sign
Test response can be altered by distant movement
Differences in ROM, resistance and symptoms involved vs. noninvolved side
Adverse response to nerve palpation
Nerves and Levels - Femoral
L2-L4
Nerves and Levels - Sciatic
L4-S3
Nerves and Levels - Fibular
L4-S1
Nerves and Levels - Tibial
S1-S2
Nerve Palpation - Sciatic
Midway btw greater troch and ischial tub
Nerve Palaption - Femoral
lateral to inguinal pulse
Nerve palpation - FIbular
palpate neck of fibula
Nerve Palpation - Tbial
posterior to medial malleolus
PROM Testing
Slump Test
SLR
Crossed SLR
Prone Knee Bend
Slump Test
Continual assessment of sx Pt seated with hands behind back, full flexion is added to thoracolumbar region while head is maintained in neutral Apply overpressure - assess Cervical flexion - asses Knee extension - assess Ankle dorsiflexion - assess Release LE components Repeat and assess on other leg
POsitive slump test if
Comparable sign is found and then with release of cervical felxion - sx are decreased or further ROM is gained
What pt history would lead you to perform a slump test
ANSWER
What tx based classifications are associated with positive neurodynamic tests?
ANSWER
SLR - increases distance nerve travels
Btw 30 and 70 degrees of SLR the length increases 2-6 mm - other structures become involved after 70 degrees
SLR
Patient in supine with NO pillow
Screen hip/knee ROM first!
SLR is done passively with knee extended until resistance or sx occur
Leg is lowered to the point just before resistance or sx and then ankle DF or passive cervical flexion is added
Hip IR and ADD can also be added
Postitive SLR
Increase in sx with cervical flexion - problem in neuromeningeal system
Crossed SLR
High Sp
Lifting of the asymptomatic leg produces pain in the symptomatic leg
Possibel cause of pos test = SIJ involvement, large or medially displaced disc herniation
Prone Knee Bend
Patient prone
Stabilize pelvis
Flex knee fully
If no sx, extend hip while maintaining knee flexion
Dura is stretched at 80-100 deg knee flexion, beyond 100 deg introduces btoh rectus and lumbar spine motion
Can do n side lying to incorporate spinal flexion (with release of neck flexion, hip ext should inc)
Normal response to Prone knee bend
Stretch.pull anterior thigh
Positive test if comparable sign is reproduced
Interventions
Accessory Lumbar PA with SLR
Flexion PPIVM with SLR
Neural Slide (slump, SLR)
Slump stretching
Neural slide intervention
Increase length of nerve bed at one joint and decrease length of nerve bed at adjacent to move relative to surrounding structures
SLR slider
Patient side lying
Spinal flexion with knee flexion and hip extension
Move into spinal ext with knee ext and hip flex, May add ankle movements PF/DF
Slump Slider
Patient seated with spinal flexion, ankle PF
Move into seated spinal extension with knee ext and ankle DF
Slump Stretching
Pt in long sitting with feet against wall to maintain DF
Therapist or pt applies pressure into cervical felxion to point of sx reproduction, hold 30 sec 2-5 reps
