Effects of simulated neural mobilization on fluid movement in cadaveric peripheral nerve sections: implications for the treatment of neuropathic pain and dysfunction

Abstract

Repetitive simulated neural mobilization, incorporating stretch/relax cycles, of excised cadaveric peripheral nerve tissue produced an increase in intraneural fluid dispersion. Neural mobilization may alter nerve tissue environment, promoting improved function and nerve health, by dispersing tissue fluid and diminishing intraneural swelling and/or pressure.

Effects of lower limb neurodynamic mobilization on intraneural fluid dispersion of the fourth lumbar nerve root: an unembalmed cadaveric investigation

“…Concerning the preliminary control nerve segments, the mean change of the dye spread length was 0.2 ± 0.6 mm, which was not statistically significant (t = − 0765; P = 0.500) nor was the average spread greater than the criterion used for a 'stabilised' dye spread (i.e. less than 0.5 mm on an average of three measures at 5-minute increments as described in the Methods section of this manuscript as well as those of Brown et al 6 and Gilbert et al 6,33 Qualitative observations At rest, the dura appeared relatively slack, likely due to the reduced cerebrospinal fluid within the dural sheath. During the mobilisation cycles, the dura filled with air/fluid upon return (to hip extension) from each lower extremity neural mobilisation (to hip flexion).…”

“…These results are consistent with similar studies that examined a comparison between these pretest/ posttest conditions, with matched controls (contralateral side). 6,33 In these previous studies, the matched controls demonstrated no significant longitudinal dye spread during the 'no-mobilisation' period. The preliminary control segments tested in this study indicated the same general behaviour of no significant change in longitudinal dye spread movement during the 'no-mobilisation' period.…”

“…The initial injection longitudinal dye spread was measured using a digital calliper (Digimax 6″ precision digital calliper, Wiha Quality Tools, LLC, Monticello, MN, 55362 USA). Measurements were taken as described previously, 6,33 including the most distinct proximal and distal borders of the dye spread ( Fig. 1).…”

“…6,33 Therefore, the current study focussed on the comparison between the pre-mobilisation and post-mobilisation measurement on the experimental limb. In addition, a preliminary observation of the control behaviour in the lumbar roots was conducted on four cadavers.…”

“…33 However, the effect of NDM on intraneural fluid dispersion within lumbar nerve roots has not been investigated.…”