A modified upper limb tension test: An investigation of responses in normal subjects

Yaxley, Gayle A; Jull, Gwendolen

doi:10.1016/s0004-9514(14)60536-5

Cited by 42 publications

(17 citation statements)

References 12 publications

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“…Most reports of ULNT reliability in asymptomatic 14,17,27,43,48,63,70,74,77,105,126 and symptomatic 17,84,103 populations have focused on measuring range of motion, not whether examiners agreed on a positive test. Four studies assessed reliability for identifying a positive ULNT.…”

Section: Reliability Of a Positive Ulntmentioning

confidence: 99%

“…23,54,63,73,77,102,126 Structural differentiation with contralateral neck sidebending increased limb responses in more than 85% of participants. 54,73,77,126 This suggests that asymptomatic individuals have a certain level of nerve mechanosensitivity. The variety of responses reported by asymptomatic individuals signifies the need to be specific about the type of sensory response that qualifies as a positive ULNT in symptomatic populations.…”

mentioning

confidence: 98%

“…FIGURE 3 shows the most common areas in which asymptomatic individuals reported sensory responses at the end of ULNT1 ME-DIAN , 23,54,63 ULNT2 MEDIAN , 63,77 and ULNT RA-DIAL . 73,126 There were no equivalent studies for ULNT ULNAR . Sensory responses were predominantly described as stretch, ache, pain, burning, and tingling.…”

mentioning

confidence: 99%

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The Validity of Upper-Limb Neurodynamic Tests for Detecting Peripheral Neuropathic Pain

Nee¹,

Jull²,

Vicenzino³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

127

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Synopsis The validity of upper-limb neurodynamic tests (ULNTs) for detecting peripheral neuropathic pain (PNP) was assessed by reviewing the evidence on plausibility, the definition of a positive test, reliability, and concurrent validity. Evidence was identified by a structured search for peer-reviewed articles published in English before May 2011. The quality of concurrent validity studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool, where appropriate. Biomechanical and experimental pain data support the plausibility of ULNTs. Evidence suggests that a positive ULNT should at least partially reproduce the patient's symptoms and that structural differentiation should change these symptoms. Data indicate that this definition of a positive ULNT is reliable when used clinically. Limited evidence suggests that the median nerve test, but not the radial nerve test, helps determine whether a patient has cervical radiculopathy. The median nerve test does not help diagnose carpal tunnel syndrome. These findings should be interpreted cautiously, because diagnostic accuracy might have been distorted by the investigators' definitions of a positive ULNT. Furthermore, patients with PNP who presented with increased nerve mechanosensitivity rather than conduction loss might have been incorrectly classified by electrophysiological reference standards as not having PNP. The only evidence for concurrent validity of the ulnar nerve test was a case study on cubital tunnel syndrome. We recommend that researchers develop more comprehensive reference standards for PNP to accurately assess the concurrent validity of ULNTs and continue investigating the predictive validity of ULNTs for prognosis or treatment response. J Orthop Sports Phys Ther 2012;42(5):413–424, Epub 8 March 2012. doi:10.2519/jospt.2012.3988

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Section: Reliability Of a Positive Ulntmentioning

confidence: 99%

mentioning

confidence: 98%

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The Validity of Upper-Limb Neurodynamic Tests for Detecting Peripheral Neuropathic Pain

Nee¹,

Jull²,

Vicenzino³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

127

View full text Add to dashboard Cite

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“…40,48 For the neuromobility tests, participants lay in supine with the side to be tested on the edge of the bed and were asked to report the first symptom of pain or discomfort and the location. The test began with shoulder girdle depression and proceeded through shoulder abduction to 90 , shoulder lateral flexion, forearm supination, wrist and finger extension, and elbow extension.…”

Section: Trigger Point Assessmentmentioning

confidence: 99%

An Exploratory Study to Determine the Relationship between Cervical Dysfunction and Perimenstrual Migraines

Horwitz

Stewart

2015

Physiotherapy Canada

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Purpose: To determine whether an association between cervical dysfunction and perimenstrual migraines exists. Methods: Forty perimenstrual migraine sufferers and 46 controls were compared. Information on the participants' ages and perceptions of neck pain and stiffness were solicited. The blinded physical examination of the cervical area consisted of postural, range of motion, muscle strength, muscle length, trigger point, neural mobility, and segmental cervical joint movement assessment. Results: The migraine group had increased perception of neck pain and stiffness (p < 0.001); reduced bilateral rotation (p ¼ 0.013); decreased muscle length in both trapezii, left sternocleidomastoid, and right occipitals (p ¼ 0.045); more pain on muscle stretch in both levator scapulae, both trapezii, left sternocleidomastoid, and both occipitals (p ¼ 0.013); increased trigger points bilaterally in the left trapezius (p ¼ 0.021), right trapezius (p ¼ 0.023), left sternocleidomastoid (p ¼ 0.0.004), and right sternocleidomastoid (p ¼ 0.021); reduced neural mobility with bilateral elbow lag (p ¼ 0.043); greater C4-C6 pain (p ¼ 0.045); and increased cervical stiffness in C5-C7 (p ¼ 0.023). There were no differences in posture and muscle strength. Decreased muscle length increased the risk of perimenstrual migraines 2.4-6.7 fold, reduced neural mobility 5.8-10.7 fold, and increased C7 stiffness 17.0 fold. Conclusion: The results suggest that an association between cervical dysfunction and perimenstrual headaches should be further explored.Key Words: cervical pain; headache; menstruation; migraine disorders. RÉ SUMÉObjectif : Cette é tude visait à dé terminer s'il y a un lien entre la dysfonction cervicale et les migraines pé rimenstruelles. Mé thodes : On a comparé 40 femmes souffrant de migraines pé rimenstruelles à 46 té moins. On a ré uni de l'information sur l'â ge des participantes et les perceptions de la douleur et de la raideur dans le cou. L'examen mé dical à l'insu de la ré gion cervicale a consisté à é valuer la posture, l'amplitude du mouvement, la force musculaire, la longueur des muscles, le point de dé clenchement, la mobilité neurale et le mouvement de l'articulation cervicale segmentaire. Ré sultats : Les patientes souffrant de migraines avaient une perception accrue de la douleur et de la raideur dans le cou (p < 0,001), une rotation bilaté rale ré duite (p ¼ 0,013); elles pré sentaient une diminution de la longueur musculaire au niveau des deux trapè zes, du sternoclé idomastoïdien gauche et des occipitaux droits (p ¼ 0,045); ressentaient plus de douleur à l'é tirement musculaire au niveau des deux muscles é lé vateurs de la scapula, des deux trapè zes, du sternoclé idomastoïdien gauche et des deux occipitaux (p ¼ 0,013); une é lé vation des points de dé clenchement des deux cô té s dans le trapè ze gauche (p ¼ 0,021), le trapè ze droit (p ¼ 0,023), le sternoclé idomastoïdien gauche (p ¼ 0,0004) et le sternoclé idomastoïdien droit (p ¼ 0,021); une ré duction de la mobilité neurale avec latence du coude de...

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“…Participants were considered to have adverse neural tension if: full mobility into the test position was not achieved, symptoms were either dissimilar to the uninvolved arm or not normal for the test, and these symptoms decreased with cervical side flexion toward the side being tested and increased with cervical side flexion to the opposite side. 6,58,71 For purposes of analysis, participants were classified according to their responses to the test into 2 categories: (1) absent (if they did not meet the criteria for adverse tension or if they exhibited signs of adverse tension but the test did not reproduce their symptoms of lateral epicondylalgia), or (2) present (if they met the criteria for adverse tension and the test reproduced their symptoms).…”

Section: Procedures and Outcome Measuresmentioning

confidence: 99%

Computer Use Associated With Poor Long-Term Prognosis of Conservatively Managed Lateral Epicondylalgia

Waugh¹,

Jaglal²,

Davis³

2004

J Orthop Sports Phys Ther

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Study Design: Multicenter prospective design with a cohort of patients with lateral epicondylalgia commencing physical therapy. Objective: To identify key factors associated with long-term prognosis of conservatively managed lateral epicondylalgia. Background: The response to conservative management of lateral epicondylalgia is inconsistent and the rate of recovery varies widely among individuals. The reasons for these discrepancies are not understood. The identification of factors associated with prognosis will aid in the prediction of patient outcomes. Methods and Measures: Sixty patients with lateral epicondylalgia, recruited from 9 sports medicine clinics and 2 hospital outpatient physical therapy departments in Ontario, Canada, were followed for 6 months. A baseline clinical assessment was conducted on each participant using standard physical therapy techniques. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and a 100-mm pain visual analog scale (VAS) were completed at baseline and 6 months later. Results: The key factor associated with both 6-month DASH and pain VAS scores was repetitive-work tasks (DASH, 9.8 [P Ͻ .01]; pain VAS, 13.1 mm [P = .0105]). A subanalysis indicated that women were more likely than men to have cervical joint signs and, among women, positive cervical articular signs were also associated with higher final DASH and pain VAS scores. Conclusions: Although many of the participants identified sports activities as the cause of their injury, these findings emphasize the importance that a patient's work tasks can have on recovery of lateral epicondylalgia. This would suggest that management should perhaps focus on work stations, postures, and behaviors.

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A modified upper limb tension test: An investigation of responses in normal subjects

Cited by 42 publications

References 12 publications

The Validity of Upper-Limb Neurodynamic Tests for Detecting Peripheral Neuropathic Pain

The Validity of Upper-Limb Neurodynamic Tests for Detecting Peripheral Neuropathic Pain

An Exploratory Study to Determine the Relationship between Cervical Dysfunction and Perimenstrual Migraines

Computer Use Associated With Poor Long-Term Prognosis of Conservatively Managed Lateral Epicondylalgia

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