Femoral nerve excursion with knee and neck movements in supine, sitting and side-lying slump: An  in vivo  study using ultrasound imaging

Sierra-Silvestre, Eva; Bosello, Francesca; Fernández‐Carnero, Josué; Hoozemans, M.J.M.; Coppieters, Michel W.

doi:10.1016/j.msksp.2018.06.007

Cited by 8 publications

(4 citation statements)

References 28 publications

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“…The hypothesis was the saphenous nerve was the source of peripheral neuropathic symptoms, therefore the combination of a neural glide with the static cup was chosen. This intervention can allow for local nerve and soft tissue stimulation during a slump motion that was perceived as threatening by the nervous system to now receive a counter-irritant stimulation to potentially alter previous output & change pain with movement [8,10,23]. As has been discussed previously, static cupping can produce tension force down to the muscle layer [10].…”

Section: Discussionmentioning

confidence: 98%

Cupping with neural glides for the management of peripheral neuropathic plantar foot pain: a case study

Escaloni¹,

Young²,

Loss

2018

Journal of Manual & Manipulative Therapy

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Background/purpose: Plantar foot pain of neural origin is a challenging diagnosis to identify and treat. The purpose of this paper is to illustrate the novel way in which cupping was utilized in conjunction with neural glides to better diagnose and manage a patient who presented with symptoms of peripheral neuropathic plantar foot pain. Case description: A 65-year-old male presented to physical therapy with the diagnosis of plantar fasciitis by an orthopedic surgeon. The presentation included a diffuse area of pain toward the medial border of the foot with a peripheral neuropathic pain description. Cupping was used to identify pain in the saphenous nerve distribution and aided in resolving symptoms with the concomitant use of lower quarter neural glides. Outcome: At discharge and 1-year follow-up, the patient had a full resolution of symptoms and a return to prior level of function. Self-report outcomes included the numeric pain rating scale and the lower extremity functional scale. Discussion: This case is the first to describe the use of cupping combined with neural glides in the diagnosis and management of peripheral neuropathic pain from the saphenous nerve that was previously diagnosed as plantar fasciitis. The proposed mechanisms behind this treatment are also reviewed. Conclusion:In patients that present with symptoms of plantar fasciitis, testing neural glides combined with cupping may be warranted to confirm or refute the presence of a peripheral neuropathic pain source. Further studies are necessary to determine the mechanisms and further utility of the combined interventions in well controlled trials.

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Section: Discussionmentioning

confidence: 98%

Cupping with neural glides for the management of peripheral neuropathic plantar foot pain: a case study

Escaloni¹,

Young²,

Loss

2018

Journal of Manual & Manipulative Therapy

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“…The face validity of structural differentiation is strongly backed up in the upper extremity with biomechanical (Coppieters & Butler 2008 ; Coppieters, Hough & Dilley 2009 ) as well as experimental pain studies (Coppieters, Alshami & Hodges 2006 ). In the lower extremity, most studies similarly show altered peripheral nerve movement during neurodynamic testing, including differentiation at distant sites (Sierra-Silvestre et al 2018 ) whilst one study did not (Ellis et al 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Does the efficacy of neurodynamic treatments depend on the presence and type of criteria used to define neural mechanosensitivity in spinally-referred leg pain? A systematic review and meta-analysis

Murape

Ainslie

Basson

et al. 2022

S. Afr. j. physiother.

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Background: It remains unclear whether definite neural mechanosensitivity (NM) is required for neural mobilisations to be beneficial in people with spinally referred leg pain.Objective: To determine whether the efficacy of neural mobilisations in patients with spinally referred leg pain depends on the presence and type of criteria used to define NM.Method: PubMed, CINAHL, Cochrane Central Register of Controlled Trials, PEDro and Science Direct were searched from 1980 to March 2020. Randomised controlled trials evaluating the efficacy of neural mobilisations on pain and disability in spinally referred leg pain were included. Studies were grouped according to the certainty of NM into NMdefinite, NMunclear, NMuntested and NMabsent. Effects on pain and disability and subgroup differences were examined.Results: We identified 21 studies in 914 patients (3 NMdefinite, 16 NMunclear, 2 NMuntested, 0 NMabsent). Meta-analysis revealed medium to large effect sizes on pain for neurodynamic compared to control interventions in NMdefinite and NMunclear groups. For disability, neurodynamic interventions had medium to large effects in NMunclear but not NMdefinite groups. NMuntested studies could not be pooled.Conclusion: The nonexistence of studies in patients with negative neurodynamic tests prevents inferences whether neural mobilisations are effective in the absence of NM. The criteria used to define NM may not impact substantially on the efficacy of neural mobilisations. The mostly high risk of bias and heterogeneity prevents firm conclusions.Clinical implications: Neural mobilisations seem beneficial to reduce pain and disability in spinally referred leg pain independent of the criteria used to interpret neurodynamic tests.

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“…A hiperflexão dos quadris pode provocar a luxação inferior e principalmente nos casos mais graves, quando combinada com a hiperflexão dos joelhos, pode levar à praxia do nervo femoral. 40 A neuropraxia do femoral está associada a um maior índice de falha no tratamento e complicações, em especial se sua recuperação levar mais que 3 dias, 41 enquanto a abdução excessiva está relacionada à osteonecrose da cabeça femoral (NAV).…”

Section: Tratamentounclassified

“…Especially in most severe cases, when combined with knee hyperflexion, it can lead to femoral nerve praxis. 40 Femoral neuropraxia leads to a higher rate of treatment failure and complications, particularly if recovery takes longer than 3 days. 41 Excessive abduction causes osteonecrosis (avascular necrosis [AVN]) of the femoral head.…”

Section: Treatmentmentioning

confidence: 99%

Displasia do desenvolvimento do quadril – Parte 1

Braga,

Júnior,

Akkari

et al. 2023

Rev Bras Ortop (Sao Paulo)

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ResumoO termo displasia do desenvolvimento quadril (DDQ) refere-se à condição na qual a articulação sofre alterações na sua formação durante os últimos meses da vida intrauterina ou nos primeiros meses após o nascimento. No espectro de apresentação, varia desde a instabilidade femuroacetabular, passando por estádios de displasia até a completa luxação. O diagnóstico precoce é fundamental para o sucesso do tratamento. A triagem através do exame clínico incluindo manobras apropriadas é imprescindível nos recém-nascidos e nas avaliações subsequentes durante o crescimento da criança.O rastreamento ultrassonográfico é indicado nos bebês sob suspeita clínica e muito mais recomendável naqueles que tiveram apresentação pélvica para o parto ou que tenham antecedentes familiares. A ultrassonografia do quadril nos primeiros meses seguida da radiografia da bacia após o 4° ou 6° mês de vida são os exames que determinam o diagnóstico e auxiliam o seguimento.O tratamento está baseado na obtenção de uma redução concêntrica e na manutenção e estabilização do quadril, propiciando a remodelação articular. Inicialmente, as órteses de flexão/abdução são a escolha; em crianças maiores pode ser necessário o uso de gesso após redução incruenta com ou sem tenotomia; redução aberta pode ser indicada e após os 18 meses as osteotomias pélvicas associadas a capsuloplastia e eventuais osteotomias acetabular e femoral.Crianças tratadas devem ser acompanhadas durante todo o seu crescimento pelo eventual risco de displasias tardias.

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Femoral nerve excursion with knee and neck movements in supine, sitting and side-lying slump: An in vivo study using ultrasound imaging

Abstract: Although the femoral nerve terminates proximal to the knee, femoral nerve excursion in the proximal thigh occurred with knee flexion; Neck flexion in Slump resulted in medial excursion.

Cited by 8 publications

References 28 publications

Cupping with neural glides for the management of peripheral neuropathic plantar foot pain: a case study

Cupping with neural glides for the management of peripheral neuropathic plantar foot pain: a case study

Does the efficacy of neurodynamic treatments depend on the presence and type of criteria used to define neural mechanosensitivity in spinally-referred leg pain? A systematic review and meta-analysis

Displasia do desenvolvimento do quadril – Parte 1

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