Ibrahim Dalia, Ahbouch Amal, Qadah Raneen Mohammed, Kim Meeyoung, Alrawaili Saud M, Moustafa Ibrahim M
Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates.
Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates.
J Clin Med. 2024 Feb 5;13(3):913. doi: 10.3390/jcm13030913.
Neurodynamic exercise is a common clinical practice used to restore neural dynamic balance. The order in which movements are performed during these exercises is believed to play a crucial role in their effectiveness. This study aimed to investigate the impact of different sequences of neurodynamic exercise on nerve root function, with a specific focus on the median nerve. Participants were assigned randomly to three experimental groups, each undergoing a different test sequence: standard, proximal-to-distal, and distal-to-proximal. Dermatomal somatosensory evoked potentials (DSSEPs) were recorded at key levels (C6, C7, C8, and T1). The findings revealed a significant influence of the movement sequence on DSSEP amplitudes. The execution of neurodynamic exercise in the proximal-to-distal sequence was associated with a notable reduction in amplitudes ( < 0.05). Conversely, the distal-to-proximal sequence resulted in increased amplitudes compared to the standard sequence ( < 0.05). This study underscores the importance of carefully considering the order of movements during neurodynamic exercising, particularly when evaluating nerve roots that lack the protective perineurium. The choice of sequence appears to have a substantial impact on nerve function, with implications for optimizing clinical neurodynamic exercise techniques.
神经动力学训练是一种常见的临床实践，用于恢复神经动力学平衡。这些训练中动作执行的顺序被认为对其效果起着关键作用。本研究旨在调查不同顺序的神经动力学训练对神经根功能的影响，特别关注正中神经。参与者被随机分配到三个实验组，每组进行不同的测试顺序：标准顺序、近端到远端顺序和远端到近端顺序。在关键水平（C6、C7、C8和T1）记录皮节体感诱发电位（DSSEPs）。研究结果显示动作顺序对DSSEP波幅有显著影响。按近端到远端顺序进行神经动力学训练与波幅显著降低相关（<0.05）。相反，与标准顺序相比，远端到近端顺序导致波幅增加（<0.05）。本研究强调了在进行神经动力学训练时仔细考虑动作顺序的重要性，特别是在评估缺乏保护性神经束膜的神经根时。顺序的选择似乎对神经功能有重大影响，这对优化临床神经动力学训练技术具有启示意义。
