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单次神经动态松动术对无症状年轻受试者关节活动度和 H 反射的急性影响:一项对照研究。

Acute effects of a single neurodynamic mobilization session on range of motion and H-reflex in asymptomatic young subjects: A controlled study.

机构信息

Quirónsalud Hospital, A Coruña, Spain.

Neuroscience and Motor Control Group (NEUROcom), University of A Coruña, Institute of Biomedical Research of A Coruña, A Coruña, Spain.

出版信息

Physiol Rep. 2023 Jun;11(12):e15748. doi: 10.14814/phy2.15748.

Abstract

Neurodynamic techniques have yielded good clinical results in the treatment of various pathologies. The objective of this study is to examine the short-term effects of neurodynamic techniques of the sciatic nerve on hip ROM (range of motion) and on the amplitude and latency of the soleus H-reflex and M-waves, in young asymptomatic subjects. In a double-blind controlled trial design, 60 young asymptomatic participants were randomly assigned into six groups with different levels of manipulation of the sciatic nerve. The passive straight leg raise test was used to evaluate the hip ROM amplitude. All evaluations were performed before, 1 min after, and 30 min after intervention. For each time-point, spinal and muscle excitability were also tested. ROM increased in all groups, but none of the treatment groups had superior effects than the group with no treatment. This means that ROM testing maneuvers increased ROM amplitude, with no add-on effect of the proposed neurodynamic techniques. Neurophysiological responses changed similarly in all groups, showing that the aftereffects were not intervention-specific. We observed a significant negative association between the change in limb temperature and the change in latencies of all potentials. ROM-testing procedures performed repeatedly increase ROM amplitude. This observation should be considered when evaluating the aftereffects of therapeutic interventions on ROM amplitude. None of the explored neurodynamic techniques produced acute aftereffects on hip ROM amplitude, spinal or muscle excitability different to the induced by the ROM testing maneuver.

摘要

神经动力学技术在治疗各种疾病方面取得了良好的临床效果。本研究旨在观察坐骨神经神经动力学技术对年轻无症状受试者髋关节 ROM(运动范围)和比目鱼肌 H 反射和 M 波振幅和潜伏期的短期影响。在一项双盲对照试验设计中,将 60 名年轻无症状参与者随机分为 6 组,对坐骨神经进行不同程度的操作。采用被动直腿抬高试验评估髋关节 ROM 幅度。所有评估均在干预前、干预后 1 分钟和 30 分钟进行。对于每个时间点,还测试了脊髓和肌肉兴奋性。所有组的 ROM 均增加,但与未治疗组相比,没有任何治疗组具有更好的效果。这意味着 ROM 测试操作增加了 ROM 幅度,而提出的神经动力学技术没有附加效果。所有组的神经生理反应变化相似,表明后效不是干预特异性的。我们观察到肢体温度变化与所有电位潜伏期变化之间存在显著负相关。重复进行的 ROM 测试程序会增加 ROM 幅度。在评估治疗干预对 ROM 幅度的后效时,应考虑这一观察结果。所探索的神经动力学技术均未产生对髋关节 ROM 幅度、脊髓或肌肉兴奋性的急性后效,与 ROM 测试操作引起的后效不同。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8520/10277214/6f5fcd30c7d8/PHY2-11-e15748-g005.jpg

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本文引用的文献

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J Orthop Sports Phys Ther. 2015 Oct;45(10):731-7. doi: 10.2519/jospt.2015.5743. Epub 2015 Aug 24.
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Manual therapy and neurodynamic mobilization in a patient with peroneal nerve paralysis: a case report.
J Chiropr Med. 2013 Sep;12(3):176-81. doi: 10.1016/j.jcm.2013.10.007.

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