Purpose The techniques used previously to assess intracapsular pressures did not allow the assessment of pressure variations in both compartments throughout the entire range of motion without puncturing the capsular tissue. Our hypothesis was that the intra-capsular pressure would be different in the lateral and acetabular compartment depending on the movement assessed. Methods Eight hip joints from four cadaveric specimens (78.5 ± 7.9 years) were assessed using intra-osseous tunnels reaching the lateral and acetabular compartments. Using injector adaptors, 2.7 ml of liquid were inserted in both compartments to simulate synovial liquid. Optic pressure transducers were used to measure pressure variations. We manually performed hip adduction, abduction, extension, flexion and internal rotation at 90° of flexion. Results Hip extension and internal rotation show the highest intra-capsular pressures in the lateral compartment with increases of 20.56 ± 19.29 and 19.27 ± 18.96 mmHg, respectively. Hip abduction and hip internal rotation showed depressurisations of − 16.86 ± 18.01 and − 31.88 ± 30.71 mmHg in the acetabular compartment, respectively. The pressures measured in the lateral compartment and in the acetabular compartment were significantly (P < 0.05) different for the hip abduction, 90° of flexion and internal rotation. Pressure variations showed that maximum intracapsular fluid pressures in the lateral compartment occur at maximum range of motion for all movements. Conclusion As an increase in pressure may produce hip pain, clinician should assess pain at maximum range of motion in the lateral compartment. The pressure measured in the acetabular compartment vary depending on the hip position. The movements assessed are used in clinical practice to evaluate hip integrity and might bring pain. The pressure variations throughout the entire range of motion are a relevant information during hip clinical assessment and might help clinicians to better understand the manifestations of pain.
Context: A specific neurodynamic mobilization for the superficial fibular nerve (SFN) has been suggested in the reference literature for manual therapists to evaluate nerve mechanosensitivity in patients. However, no biomechanical studies examined the ability of this technique to produce nerve strain. Therefore, mechanical specificity of this technique is not yet established. Objective: The aim of our study was to test whether this examination and treatment technique was producing nerve strain in the fresh frozen cadaver and the contribution of each motion to total longitudinal strain. Design: Quantitative original research, controlled laboratory study Methods: A differential variable reluctance transducer was inserted in ten SFN from six fresh cadavers to measure strain during the mobilization. A specific sequence of plantar flexion (PF), ankle inversion (INV), straight leg raise (SLR) position and 30{degree sign} of hip adduction (ADD) was applied to the lower limb. The mobilization was repeated at 0°, 30°, 60° and 90° of Straight Leg Raise (SLR) position to measure the impact of hip flexion position. Findings: Compared to a resting position, this neurodynamic mobilization produced a significant amount of strain in the SFN (7.93% ± 0.51 P < 0.001). PF (59.34% ± 25.82) and INV (32.80% ± 21.41) accounted for the biggest proportion of total strain during the mobilization. No significant difference was reported between different hip flexion positions. Hip ADD did not significantly contribute to final strain (0.39% ± 10.42 P> 0,05) although high subject variability exists. Conclusion: Ankle motions should be considered the most important during neurodynamic assessment of the SFN for distal entrapment. These results suggest that this technique produces sufficient strain in the SFN and could therefore be evaluated In Vivo for correlation with mechanosensitivity
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