Aberrant protective force generation during neural provocation testing and the effect of treatment in patients with neurogenic cervicobrachial pain

Coppieters, MW, Stappaerts, KH, Wouters, LL and Janssens, K (2003) Aberrant protective force generation during neural provocation testing and the effect of treatment in patients with neurogenic cervicobrachial pain. Journal of Manipulative And Physiological Therapeutics, 26 2: 99-106.


Author Coppieters, MW
Stappaerts, KH
Wouters, LL
Janssens, K
Title Aberrant protective force generation during neural provocation testing and the effect of treatment in patients with neurogenic cervicobrachial pain
Journal name Journal of Manipulative And Physiological Therapeutics   Check publisher's open access policy
ISSN 0161-4754
Publication date 2003
Sub-type Article (original research)
DOI 10.1067/mmt.2003.16
Volume 26
Issue 2
Start page 99
End page 106
Total pages 8
Editor Dana Lawrence
Place of publication USA
Publisher Mosby, Inc
Collection year 2003
Language eng
Subject C1
321024 Rehabilitation and Therapy - Occupational and Physical
730114 Skeletal system and disorders (incl. arthritis)
Abstract Background: Observation of the occurrence of protective muscle activity is advocated in assessment of the peripheral nervous system by means of neural provocation tests. However, no studies have yet demonstrated abnormal force generation in a patient population. Objectives: To analyze whether aberrations in shoulder girdle-elevation force during neural tissue provocation testing for the median nerve (NTPTI) can be demonstrated, and whether possible aberrations can be normalized following cervical mobilization. Study Design: A single-blind randomized comparative controlled study. Setting: Laboratory setting annex in a manual therapy teaching practice. Participants: Twenty patients with unilateral or bilateral neurogenic cervicobrachial pain. Methods: During the NTPTI, we used a load cell and electrogoniometer to record continuously the shoulder-girdle elevation force in relation to the available range of elbow extension. Following randomization, we analyzed the immediate treatment effects of a cervical contralateral lateral glide mobilization technique (experimental group) and therapeutic ultrasound (control group). Results: On the involved side, the shoulder-girdle elevation force occur-red earlier, and the amount of force at the end of the test was substantially, though not significantly, greater than that on the uninvolved side at the corresponding range of motion. Together with a significant reduction in pain perception after cervical mobilization, a clear tendency toward normalization of the force curve could be observed, namely, a significant decrease in force generation and a delayed onset. The control group demonstrated no differences. Conclusions: Aberrations in force generation during neural, provocation testing are present in patients with neurogenic pain and can be normalized with appropriate treatment modalities.
Keyword Health Care Sciences & Services
Integrative & Complementary Medicine
Rehabilitation
Chiropractic Manipulation
Median Neuropathy
Neurodynamic Test
Peripheral Neurogenic Pain
Cervical Manipulation
Upper-limb Pain
Lumbar Stiffness
Posteroanterior
Responses
Tension
Nerve
Spine
Q-Index Code C1

 
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