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Tension of the Ulnar, Median, and Radial Nerves During Ulnar Nerve Neurodynamic Testing: Observational Cadaveric Study

Nicole Manvell, Joshua J. Manvell, Suzanne J. Snodgrass, Susan A. Reid
DOI: 10.2522/ptj.20130536 Published 1 June 2015
Nicole Manvell
N. Manvell, BSc(Physio)Hons, Discipline of Physiotherapy, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia.
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Joshua J. Manvell
J.J. Manvell, BSc(Physio)Hons, Discipline of Physiotherapy, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle.
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Suzanne J. Snodgrass
S.J. Snodgrass, BSc(PhysTher), MMedSc(Physio), PhD, Discipline of Physiotherapy, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales 23008, Australia.
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Susan A. Reid
S.A. Reid, BAppSc(Phty), MMedSc(Phty), PostGradDip(ManipPhty), BPharm, Discipline of Physiotherapy, Australian Catholic University, North Sydney, New South Wales, Australia.
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Figures

Figure 1.
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Figure 1.

Anterior and lateral views of 2 variations of the current neurodynamic test for the ulnar nerve (ULNT3: scapular depression, shoulder abduction and external rotation, elbow flexion, forearm pronation, and wrist and finger extension). (A) and (B): the current test with addition of horizontal abduction (ULNT3+H.Abd); (C) and (D) the current test with the addition of horizontal abduction and internal rotation (ULNT3+H.Abd+IR). Arrows illustrate the direction of the additional horizontal abduction away from the mid-transverse plane.

Figure 2.
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Figure 2.

The 3 buckle force transducers in situ attached (from left to right) to the median, ulnar, and radial nerves in the axilla.

Figure 3.
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Figure 3.

Schematic of the buckle force transducer with a nerve segment.

Tables

Table 2.
Table 2.

Intrarater and Interrater Reliability, SEM, and SDD95 of Tension Measurements for the 5 Neurodynamic Test Positions for the Ulnar Nervea

  • ↵a ULNT3=ulnar nerve upper limb neurodynamic test (scapular depression, abduction and external rotation, elbow flexion, forearm pronation, and wrist and finger extension) as described by Butler10; ULNT3+IR=ULNT3 with internal rotation; ULNT3+Sup=ULNT3 with forearm supination; ULNT3+H.Abd=ULNT3 with horizontal abduction; ULNT3+H.Abd+IR=ULNT3 with horizontal abduction and internal rotation; ICC=intraclass correlation coefficient; 95% CI=95% confidence interval; SEM=standard error of measurement; SDD95=smallest detectable difference at 95% CI. The second examiner did not record data for ULNT3+IR and ULNT3+Sup.

Table 1.
Table 1.

Five Upper Limb Positions Used to Compare Tension in the Nerves of the Upper Limba

  • ↵a ULNT3=ulnar nerve upper limb neurodynamic test (scapular depression, abduction and external rotation, elbow flexion, forearm pronation, and wrist and finger extension) as described by Butler10; ULNT3+IR=ULNT3 with internal rotation; ULNT3+Sup=ULNT3 with forearm supination; ULNT3+H.Abd=ULNT3 with horizontal abduction; ULNT3+H.Abd+IR=ULNT3 with horizontal abduction and internal rotation. Movements in bold font have been added to the end position of ULNT3.

Table 3.
Table 3.

Tension (in Newtons) of the Ulnar, Median, and Radial Nerves and Mean Differences in Tension Among the Nerves for Each of the 5 Test Positionsa

  • ↵a Measurements are expressed as mean (SD) [95% confidence interval]. ULNT3=ulnar nerve upper limb neurodynamic test (scapular depression, abduction and external rotation, elbow flexion, forearm pronation, and wrist and finger extension) as described by Butler9; ULNT3+IR=ULNT3 with internal rotation; ULNT3+Sup=ULNT3 with forearm supination; ULNT3+H.Abd=ULNT3 with horizontal abduction; ULNT3+H.Abd+IR=ULNT3 with horizontal abduction and internal rotation.

  • b Significantly different mean tension (P≤.01) in this position than in ULNT3.

  • c Significantly different tension (P<.05) between 2 nerves (eg, ulnar and median) for a given position (eg, ULNT3).

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Vol 95 Issue 6 Table of Contents
Physical Therapy: 95 (6)

Issue highlights

  • Management of Falls in Community-Dwelling Older Adults
  • Aerobic Capacity and Walking Capacity After Stroke
  • Modified Dynamic Gait Index: Medical Diagnoses and Patterns of Performance
  • Environmental Framework for the Modified Dynamic Gait Index
  • Factors Contributing to 50-ft Walking Speed
  • Reported Characteristics in Clinical Trials
  • Ulnar Nerve Neurodynamic Testing
  • Further Development and Validation of the AHEMD-IS
  • Power and Promise of Narrative
  • Development and Evaluation of Self-Management and Task-Oriented Approach to Rehabilitation Training
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Tension of the Ulnar, Median, and Radial Nerves During Ulnar Nerve Neurodynamic Testing: Observational Cadaveric Study
Nicole Manvell, Joshua J. Manvell, Suzanne J. Snodgrass, Susan A. Reid
Physical Therapy Jun 2015, 95 (6) 891-900; DOI: 10.2522/ptj.20130536

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Tension of the Ulnar, Median, and Radial Nerves During Ulnar Nerve Neurodynamic Testing: Observational Cadaveric Study
Nicole Manvell, Joshua J. Manvell, Suzanne J. Snodgrass, Susan A. Reid
Physical Therapy Jun 2015, 95 (6) 891-900; DOI: 10.2522/ptj.20130536
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