An experimental pain model to investigate the specificity of the neurodynamic test for the median nerve in the differential diagnosis of hand symptoms

Coppieters, M. W., Alshami, A. M. and Hodges, P. W. (2006) An experimental pain model to investigate the specificity of the neurodynamic test for the median nerve in the differential diagnosis of hand symptoms. Archives of Physical Medicine And Rehabilitation, 87 10: 1412-1417. doi:10.1016/j.apmr.2006.06.012


Author Coppieters, M. W.
Alshami, A. M.
Hodges, P. W.
Title An experimental pain model to investigate the specificity of the neurodynamic test for the median nerve in the differential diagnosis of hand symptoms
Journal name Archives of Physical Medicine And Rehabilitation   Check publisher's open access policy
ISSN 0003-9993
Publication date 2006
Sub-type Article (original research)
DOI 10.1016/j.apmr.2006.06.012
Volume 87
Issue 10
Start page 1412
End page 1417
Total pages 6
Editor Jaffe, K. M.
Place of publication Philadelphia
Publisher W.B. Saunders & Co
Collection year 2006
Language eng
Subject C1
321024 Rehabilitation and Therapy - Occupational and Physical
730114 Skeletal system and disorders (incl. arthritis)
Abstract Objective: To indirectly assess the specificity of the neurodynamic test for the median nerve using an experimental pain model. Design: Repeated-measures design. Setting: Laboratory setting. Participants: Twenty asymptomatic participants in whom hand symptoms were induced by infusion of hypertonic saline into the thenar muscles. Interventions: Not applicable. Main Outcome Measures: Pain intensity of the induced hand symptoms and size of the painful area were evaluated in 8 different arm positions, which correspond with different stages of the neurodynamic test for the median nerve. These positions have a variable degree of median nerve provocation at the wrist. Results: Because the induced symptoms had a non-neural origin, changes in symptom provocation with the neurodynamic test would have indicated poor specificity. However, there were no statistically significant differences in pain perception (P >=.22) and the recorded differences were negligible from a clinical perspective. Conclusions: Taking into consideration the limitations of an experimental pain model, this study indirectly confirms the specificity of the neurodynamic test for the median nerve. The results of this study, together with previous studies that demonstrated a high sensitivity, support the use of the neurodynamic test for the median nerve to differentially diagnose neurogenic disorders, such as carpal tunnel syndrome, from other wrist and hand pathologies.
Keyword Rehabilitation
Sport Sciences
carpal tunnel syndrome
diagnosis
entrapment neuropathies
median nerve
rehabilitation
reliability and validity
Carpal-tunnel-syndrome
Induced Muscle Pain
Pressure
Strain
Electromyography
Neuropathies
Conduction
Impact
Q-Index Code C1

 
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