Effect of cervical contralateral lateral flexion on the median nerve and fascia at the wrist – Cadaveric study
Pérez-Bellmunt, Albert ; López-de-Celis, Carlos ; Estébanez-de-Miguel, Elena (Universidad de Zaragoza) ; Pérez-Rey, Jorge (Universidad de Zaragoza) ; Shacklock, Michael ; Ortiz-Miguel, Sara ; Bueno-Gracia, Elena (Universidad de Zaragoza)
Resumen: Background
Neurodynamic tests are an essential aspect of the physical examination of the patient when suspicion of neural involvement exists. A manoeuvre that is hypothesised to move nerves differentially relative to other structures (structural differentiation) has been proposed as a necessary part of neurodynamic testing for differential diagnosis. However, although the specificity of structural differentiation for peripheral nerve over muscle has been demonstrated in some body regions, no study has tested specificity of nerve movement relative to fascia.
Objectives
The aim of this study was to measure the effect of the cervical contralateral lateral flexion (CCLF) as an structural differentiation manoeuvre for the median nerve compared to fascia (superficial and deep) at the wrist during the upper limb neurodynamic test 1 (ULNT1).
Design
A cross-sectional study was performed in 5 fresh frozen cadavers.
Methods
Excursion and strain in the fascia (superficial and deep) and the median nerve were measured at the wrist with structural differentiation during the ULNT1. KINOVEA software was used to measure kinematic parameters.
Results
CCLF resulted in significant proximal excursion in the median nerve (p < 0.001*) but not in the strain. CCLF neither produced changes in strain nor excursion in the superficial and deep fascia (p > 0.05).
Conclusion
This study showed that CCLF produced significant differential excursion in the median nerve at the wrist compared to the local superficial and deep fascia during the ULNT1. The data support CCLF in mechanical differentiation between nerve and fascia in this area in diagnosis of local sources of wrist pain.
Idioma: Inglés
DOI: 10.1016/j.msksp.2024.103146
Año: 2024
Publicado en: MUSCULOSKELETAL SCIENCE AND PRACTICE 73 (2024), 103146 [5 pp.]
ISSN: 2468-8630
Factor impacto JCR: 2.2 (2024)
Categ. JCR: REHABILITATION rank: 43 / 173 = 0.249 (2024) - Q1 - T1
Factor impacto SCIMAGO: 0.85 - Physical Therapy, Sports Therapy and Rehabilitation (Q1)
Tipo y forma: Article (Published version)
Área (Departamento): Area Anatom.Embriol.Humana (Dpto. Anatom.Histolog.Humanas)
Área (Departamento): Área Fisioterapia (Dpto. Fisiatría y Enfermería)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material.
Exportado de SIDERAL (2025-09-22-14:39:54)
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Neurodynamic tests are an essential aspect of the physical examination of the patient when suspicion of neural involvement exists. A manoeuvre that is hypothesised to move nerves differentially relative to other structures (structural differentiation) has been proposed as a necessary part of neurodynamic testing for differential diagnosis. However, although the specificity of structural differentiation for peripheral nerve over muscle has been demonstrated in some body regions, no study has tested specificity of nerve movement relative to fascia.
Objectives
The aim of this study was to measure the effect of the cervical contralateral lateral flexion (CCLF) as an structural differentiation manoeuvre for the median nerve compared to fascia (superficial and deep) at the wrist during the upper limb neurodynamic test 1 (ULNT1).
Design
A cross-sectional study was performed in 5 fresh frozen cadavers.
Methods
Excursion and strain in the fascia (superficial and deep) and the median nerve were measured at the wrist with structural differentiation during the ULNT1. KINOVEA software was used to measure kinematic parameters.
Results
CCLF resulted in significant proximal excursion in the median nerve (p < 0.001*) but not in the strain. CCLF neither produced changes in strain nor excursion in the superficial and deep fascia (p > 0.05).
Conclusion
This study showed that CCLF produced significant differential excursion in the median nerve at the wrist compared to the local superficial and deep fascia during the ULNT1. The data support CCLF in mechanical differentiation between nerve and fascia in this area in diagnosis of local sources of wrist pain.
Idioma: Inglés
DOI: 10.1016/j.msksp.2024.103146
Año: 2024
Publicado en: MUSCULOSKELETAL SCIENCE AND PRACTICE 73 (2024), 103146 [5 pp.]
ISSN: 2468-8630
Factor impacto JCR: 2.2 (2024)
Categ. JCR: REHABILITATION rank: 43 / 173 = 0.249 (2024) - Q1 - T1
Factor impacto SCIMAGO: 0.85 - Physical Therapy, Sports Therapy and Rehabilitation (Q1)
Tipo y forma: Article (Published version)
Área (Departamento): Area Anatom.Embriol.Humana (Dpto. Anatom.Histolog.Humanas)
Área (Departamento): Área Fisioterapia (Dpto. Fisiatría y Enfermería)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material. Exportado de SIDERAL (2025-09-22-14:39:54)
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Articles > Artículos por área > Anatomía y Embriología Humana
Articles > Artículos por área > Fisioterapia
Record created 2024-07-31, last modified 2025-09-23