Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, United Kingdom; Fysio-Experts, Research Department, Hazerswoude, the Netherlands.
Department of Physiotherapy, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand; Active Living and Rehabilitation: Aotearoa New Zealand, Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
Musculoskelet Sci Pract. 2021 Apr;52:102349. doi: 10.1016/j.msksp.2021.102349. Epub 2021 Feb 16.
A segmental, contra-lateral cervical lateral glide (CCLG) mobilization technique is effective for patients with cervical radiculopathy (CR). The CCLG technique induces median nerve sliding in healthy individuals, but this has not been assessed in patients with CR.
This study aimed to 1) assess longitudinal excursion of the median nerve in patients with CR and asymptomatic participants during a CCLG movement, 2) reassess nerve excursions following an intervention at a 3-month follow-up in patients with CR and 3) correlate changes in nerve excursions with changes in clinical signs and symptoms.
Case-control study.
During a computer-controlled mechanically induced CCLG, executed by the Occiflex™, longitudinal median nerve excursion was assessed at the wrist and elbow with ultrasound imaging (T0) in 20 patients with CR and 20 matched controls. Patients were re-assessed at a 3-month follow-up (T1), following conservative treatment including neurodynamic mobilization.
There was a significant difference between patients and controls in the excursion of the median nerve at both the wrist (Mdn = 0.50 mm; IQR = 0.13-1.30; 2.10 mm (IQR = 1.42-2.80, p < 0.05)) and elbow (Mdn = 1.21 mm (IQR = 0.85-1.94); 3.49 mm (IQR = 2.45-4.24, p < 0.05)) respectively at T0. There was also a significant increase in median nerve excursion at both sites between T0 and T1 in those with CR (Mdn = 1.96, 2.63 respectively). Wilcoxon Signed-Ranks Test indicated median pre-test ranks (Mdn = 0.5, 1.21; Z = - 3.82, p < 0.01; Z = -3.78, p < 0.01 respectively) and median post-test ranks. There was a strong correlation between improvement in median nerve excursion at the elbow at T1 and improvement in pain intensity (r = 0.7, p < 0.001) and functional limitations (r = 0.6, p < 0.01).
Longitudinal median nerve excursion differs significantly between patients with CR and asymptomatic volunteers at baseline, but this difference is no longer present after 3 months of conservative physiotherapy management. Improvement in nerve excursion correlates with improvement in clinical signs and symptoms.
颈椎侧滑术（CCLG）是一种分段的、对侧颈椎侧滑技术，对神经根型颈椎病（CR）患者有效。CCLG 技术可诱导健康个体正中神经滑动，但尚未在 CR 患者中进行评估。
本研究旨在 1）评估 CR 患者和无症状参与者在 CCLG 运动过程中正中神经的纵向位移，2）在 3 个月的随访中对 CR 患者进行干预后重新评估神经位移，3）将神经位移的变化与临床体征和症状的变化相关联。
病例对照研究。
在由 Occiflex™执行的计算机控制的机械诱导 CCLG 过程中，通过超声成像（T0）在手腕和肘部评估 20 例 CR 患者和 20 名匹配对照者的正中神经纵向位移。在保守治疗（包括神经动态松动）后 3 个月（T1）时对患者进行重新评估。
T0 时，患者与对照组在手腕（中位数=0.50mm；IQR=0.13-1.30；2.10mm（IQR=1.42-2.80，p<0.05））和肘部（中位数=1.21mm（IQR=0.85-1.94）；3.49mm（IQR=2.45-4.24，p<0.05））的正中神经位移存在显著差异。在 CR 患者中，T0 与 T1 之间在两个部位的正中神经位移也有显著增加（中位数=1.96，2.63）。Wilcoxon 符号秩检验表明，中位数预测试等级（中位数=0.5，1.21；Z=-3.82，p<0.01；Z=-3.78，p<0.01）和中位数后测试等级。T1 时肘部正中神经位移的改善与疼痛强度（r=0.7，p<0.001）和功能限制（r=0.6，p<0.01）的改善有很强的相关性。
CR 患者与无症状志愿者在基线时正中神经的纵向位移有显著差异，但在 3 个月的保守物理治疗管理后，这种差异不再存在。神经位移的改善与临床体征和症状的改善相关。
