Athletic Training Services, Boston University, Boston, MA,USA.
Primary Care Sports Medicine, Ochsner Andrews Sports Medicine Institute, Baton Rouge, LA,USA.
J Sport Rehabil. 2022 Sep 1;31(8):1105-1110. doi: 10.1123/jsr.2021-0268. Print 2022 Nov 1.
Pain is a common complaint following an orthopedic injury; however, the exact cause of nociception can be complex. Multiple tissues can generate a patient's complaint of pain, such as the skin, muscle, ligaments, tendon, nerves, and bones. Regarding the somatosensory system, inflammation around the nerve can create pain and alter movement coordination; this information has resulted in increased awareness of neurodynamic assessments and exercises. Neurodynamic assessments and exercises provide a unique paradigm to effectively assess and treat neural tissue, which may not commonly be considered within the traditional orthopedic examination.
In college athletes with musculoskeletal pain and activity impairments, does the use of neurodynamic exercises improve pain or function?
Of the 5 studies, all consisted of chronic injuries with 3 involving upper-extremity pathologies and 2 focusing on lower-extremity pathologies. All 5 studies noted short- and long-term improvement following the incorporation of neurodynamic sliders or tensioners into the treatment plan. Four of the studies had follow-up periods greater than 30 days with sustained improvement on patient outcomes. Only 2 studies described a progression of neurodynamic exercises through sliders and tensioners. Three studies utilized a set/repetition format for exercise prescription, whereas a fourth used a time-based format, and a fifth article utilized both. Finally, 4 studies utilized neurodynamic assessments to identify whether there was a neural component to the patient's presentation (eg, peripheral nerve mechanosensitivity).
In individuals with musculoskeletal impairments, evidence exists to support the use of neurodynamic exercises, such as sliders and tensioners, to improve pain and pain-related disability when neural sensitivity exists.
Grade C evidence exists to support the use of neurodynamic exercises in college athletes with a musculoskeletal impairment.
疼痛是骨科损伤后的常见主诉；然而，疼痛的确切原因可能很复杂。多种组织都可能引起患者疼痛主诉，如皮肤、肌肉、韧带、肌腱、神经和骨骼。关于躯体感觉系统，神经周围的炎症会引起疼痛并改变运动协调性；这一信息导致人们越来越关注神经动觉评估和练习。神经动觉评估和练习为有效评估和治疗神经组织提供了独特的范例，而这些组织在传统的骨科检查中可能不常被考虑。
在有肌肉骨骼疼痛和活动障碍的大学生运动员中，使用神经动觉练习是否能改善疼痛或功能？
在这 5 项研究中，所有研究均涉及慢性损伤，其中 3 项涉及上肢病变，2 项涉及下肢病变。所有 5 项研究均指出，在将神经动觉滑板或张力器纳入治疗计划后，短期和长期均有改善。其中 4 项研究的随访期超过 30 天，患者结局的改善持续存在。只有 2 项研究描述了通过滑板和张力器逐步进行神经动觉练习。有 3 项研究采用了设定/重复的运动处方格式，而第 4 项研究采用了基于时间的格式，第 5 项研究则同时采用了这两种格式。最后，有 4 项研究利用神经动觉评估来确定患者的表现是否存在神经成分（例如，周围神经机械敏感性）。
在有肌肉骨骼障碍的个体中，有证据支持使用神经动觉练习，如滑板和张力器，在存在神经敏感性时可以改善疼痛和与疼痛相关的残疾。
存在 C 级证据支持在有肌肉骨骼障碍的大学生运动员中使用神经动觉练习。
