Entrapment neuropathies (EN), such as carpal tunnel syndrome and cervical radiculopathy, comprise the most common conditions that affect the peripheral nervous system. ENs have been reported to affect 2–15% of workers with associated financial costs exceeding 2 billion dollars each year in the USA.

The diagnosis of EN is based on information gathered during history taking and physical examination, which is often confirmed via electrophysiological studies and/or diagnostic imaging. Confirmatory diagnostic imaging and electrophysiological studies, however, are costly and may involve prolonged waiting times for patients; thus, it would be useful to establish accurate clinical examination tests for diagnosing EN.

Neurodynamic tests attempt to identify changes of mechanosensitivity which are affected by the mechanical, electrical and chemical properties of the nervous system. Structures surrounding the nerves can apply mechanical or chemical stimuli with consequential venous congestion, impaired axoplasmic flow, inflammation and the development of mechanosensitivity. A neurodyamic test is considered positive if it can reproduce the patient's symptoms and if those symptoms can be altered through structural differentiation. The objective of ULNTs is to put stress on the neurological structures of the upper limb, analogous to what occurs during straight leg raise testing. The shoulder, elbow, forearm, wrist and fingers are sequentially placed in specific positions such that stress is place on the tested nerve.

The purpose of this study was to review the literature to ascertain the level of diagnostic accuracy for ULNTs when compared to diagnostic imaging and/or electrophysiologic studies, and how the results from ULNTs can be interpreted when assessing patients with arm and/or neck symptoms…LOG IN OR SUBSCRIBE TO ACCESS THE FULL REVIEW!

THIS WEEK'S RESEARCH REVIEW:

“Diagnostic Accuracy of Upper Limb Neurodynamic Tests”

This paper was published in Musculoskeletal Science and Practice (2019) and this Review is posted in Recent Reviews, Clinical Testing & Procedures, Cervical Spine - Disc & Neurological and the 2019 Archive.
ULTT review

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