2006 Young Investigator Award Winner: Lumbosacral Nerve Root Displacement and Strain

Gilbert, Kerry K.; Brismée, Jean‐Michel; Collins, Dwayne L.; James, C. Roger; Shah, Rinoo V.; Sawyer, Stanley; Sizer, Phillip S.

doi:10.1097/brs.0b013e318067dd72

Cited by 46 publications

(11 citation statements)

References 38 publications

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“…Previous research has demonstrated that the amount of inherent tension to which a peripheral nerve is exposed can have a direct influence on the amount of nerve excursion available when the limb moves 1 – 4 . Although nerve tension was not quantified, the results of the current study suggest that the assumed increase in generalised neural tension applied to the spinal cord and lumbo-sacral nerve roots by slump-sitting did not alter sciatic nerve excursion.…”

Section: Discussioncontrasting

confidence: 45%

“…However, the argument for anatomic distance and relative neural tension is controversial. From their cadaver based research, Gilbert et al 1 concluded that the addition of ankle dorsiflexion to the SLR caused a significant decrease in displacement of the L5 and S1 nerve roots. In regard to nerve root strain, it was evident that ankle dorsiflexion resulted in greater strain, however this did not reach significance.…”

Section: Discussionmentioning

confidence: 99%

“…For example, a cadaver study, which examined the straight-leg raise (SLR) test, found there was less excursion of the tibial nerve 1 when the nerve was pre-tensioned with ankle dorsiflexion, and the reverse when the ankle was plantarflexed and the nerve tract unloaded. In vivo studies of the median 2 , 3 and ulnar nerves 4 found that when the nerve tract was pre-tensioned less nerve excursion occurred following wrist movement; the reverse trend was observed when the nerve tract was unloaded.…”

Section: Introductionmentioning

confidence: 99%

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The effect of spinal position on sciatic nerve excursion during seated neural mobilisation exercises: an in vivo study using ultrasound imaging

Ellis

Osborne

Whitfield

et al. 2016

Journal of Manual & Manipulative Therapy

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ObjectivesResearch has established that the amount of inherent tension a peripheral nerve tract is exposed to influences nerve excursion and joint range of movement (ROM). The effect that spinal posture has on sciatic nerve excursion during neural mobilisation exercises has yet to be determined. The purpose of this research was to examine the influence of different sitting positions (slump-sitting versus upright-sitting) on the amount of longitudinal sciatic nerve movement during different neural mobilisation exercises commonly used in clinical practice.MethodsHigh-resolution ultrasound imaging followed by frame-by-frame cross-correlation analysis was used to assess sciatic nerve excursion. Thirty-four healthy participants each performed three different neural mobilisation exercises in slump-sitting and upright-sitting. Means comparisons were used to examine the influence of sitting position on sciatic nerve excursion for the three mobilisation exercises. Linear regression analysis was used to determine whether any of the demographic data represented predictive variables for longitudinal sciatic nerve excursion.ResultsThere was no significant difference in sciatic nerve excursion (across all neural mobilisation exercises) observed between upright-sitting and slump-sitting positions (P = 0.26). Although greater body mass index, greater knee ROM and younger age were associated with higher levels of sciatic nerve excursion, this model of variables offered weak predictability (R2 = 0.22).DiscussionFollowing this study, there is no evidence that, in healthy people, longitudinal sciatic nerve excursion differs significantly with regards to the spinal posture (slump-sitting and upright-sitting). Furthermore, although some demographic variables are weak predictors, the high variance suggests that there are other unknown variables that may predict sciatic nerve excursion. It can be inferred from this research that clinicians can individualise the design of seated neural mobilisation exercises, using different seated positions, based upon patient comfort and minimisation of neural mechanosensitivity with the knowledge that sciatic nerve excursion will not be significantly influenced.

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Section: Discussioncontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effect of spinal position on sciatic nerve excursion during seated neural mobilisation exercises: an in vivo study using ultrasound imaging

Ellis

Osborne

Whitfield

et al. 2016

Journal of Manual & Manipulative Therapy

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“…8 Last, a study using 5 unembalmed cadavers (age range, 72-88 years) found that ankle mobility was limited to between -5° and 5° of dorsiflexion without cutting the calcaneal tendon. 9,10 These findings suggest that the limitations in hip and ankle ranges of motion found in the present study are likely due to age-related changes in this specific sample. Despite the limited range of motion, the maximal increase in strain that was observed in our study (7% at the hip and ankle) is representative of maximal increases in nerve strain when using fresh or unembalmed cadavers.…”

Section: Discussionmentioning

confidence: 46%

Impact of Movement Sequencing on Sciatic and Tibial Nerve Strain and Excursion During the Straight Leg Raise Test in Embalmed Cadavers

Boyd¹,

Topp²,

Coppieters³

2013

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Laboratory study, repeated-measures design. Objectives To quantify differences in sciatic and tibial nerve biomechanics (strain and excursion) during common variations of the straight leg raise (SLR) test. Background Hip flexion and ankle dorsiflexion are the primary movement components of the SLR. It has been suggested that the nervous system is loaded differently when ankle dorsiflexion is added before or after hip flexion. There are, however, no data to either support or refute this suggestion. Methods Strain and excursion in the sciatic and tibial nerve were measured in the hip, knee, and ankle regions during 2 movement sequences for the SLR test in 10 embalmed cadavers. The proximal-to-distal sequence consisted of hip flexion followed by ankle dorsiflexion; the distal-to-proximal sequence consisted of ankle dorsiflexion followed by hip flexion. Results In the SLR end position, strain and excursion were comparable for both sequences for the sciatic and tibial nerve at the knee (P>.24). Strain in the tibial nerve at the ankle was greater with the proximal-to-distal sequence (P = .008), but the actual difference was small (0.8%). The pattern of strain increase and nerve excursion varied between sequences (P≤.009), with nerve strain increasing earlier and being maintained longer in regions closest to the joint that was moved first in the movement sequence. Conclusion Varying the movement sequence does not substantially impact excursion and strain in the end position of the SLR. Therefore, if neurodynamic test sequencing is useful in the differential diagnosis of neuropathies, it is not likely due to differences in strain in the end position of testing. J Orthop Sports Phys Ther 2013;43(6):398–403. Epub 30 April 2013. doi:10.2519/jospt.2013.4413

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“…While not measured, we do not believe that hamstring extensibility was significantly affected by changes in the displacement or strain of the lumbosacral nerve roots during iSLR testing. By stabilizing the lumbar spine and using a fixed ankle position we have controlled these potentially confounding variables that have been observed to increase spinal nerve root tension [32]. Finally, the two measures of passive stiffness were based on the slope through the common range of motion (20 to 50° hip flexion) and the maximal applied torque.…”

Section: Discussionmentioning

confidence: 99%

Lower hamstring extensibility in men compared to women is explained by differences in stretch tolerance

Marshall

Siegler

2014

BMC Musculoskelet Disord

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BackgroundThis study examined whether passive hamstring tissue stiffness and/or stretch tolerance explain the relationship between sex and hamstring extensibility.MethodsNinety healthy participants, 45 men and 45 women (mean ± SD; age 24.6 ± 5.9 years, height 1.72 ± 0.09 m, weight 74.6 ± 14.1 kg) volunteered for this study. The instrumented straight leg raise was used to determine hamstring extensibility and allow measurement of stiffness and stretch tolerance (visual analog pain score, VAS).ResultsHamstring extensibility was 9.9° greater in women compared to men (p = 0.003). VAS scores were 16 mm lower in women (p = 0.001). Maximal stiffness (maximal applied torque) was not different between men and women (p = 0.42). Passive stiffness (slope from 20-50° hip flexion) was 0.09 Nm.°-1 lower in women (p = 0.025). For women, linear and stepwise regression showed that no predictor variables were associated with hamstring extensibility (adjusted r2 = -0.03, p = 0.61). For men, 44% of the variance in hamstring extensibility was explained by VAS and maximal applied torque (adjusted r2 = 0.44, p < 0.001), with 41% of the model accounted for by the relationship between higher VAS scores and lower extensibility (standardized β coefficient = -0.64, p < 0.001).ConclusionsThe results of this study suggest that stretch tolerance and not passive stiffness explains hamstring extensibility, but this relationship is only manifest in men.

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2006 Young Investigator Award Winner: Lumbosacral Nerve Root Displacement and Strain

Abstract: Prepositions of the SLR test alter the displacement and possibly the strain of the lumbosacral nerve roots in the lateral recess.

Cited by 46 publications

References 38 publications

The effect of spinal position on sciatic nerve excursion during seated neural mobilisation exercises: an in vivo study using ultrasound imaging

The effect of spinal position on sciatic nerve excursion during seated neural mobilisation exercises: an in vivo study using ultrasound imaging

Impact of Movement Sequencing on Sciatic and Tibial Nerve Strain and Excursion During the Straight Leg Raise Test in Embalmed Cadavers

Lower hamstring extensibility in men compared to women is explained by differences in stretch tolerance

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