Neural mobilization as a therapeutic option in the treatment of stroke.

Abstract

Introduction: The neural mobilization is a technique aimed at functional recovery of the nervous system and structures innervated by it. However, little is known about its effects in patients affected by stroke (CVA). Objective: To review and integrate studies that investigated the effects of neural mobilization (NM) in the treatment of patients with stroke. Method: an integrative review of scientific studies with primary and secondary data, both addressing the NM in the treatment of spasticity, flexibility and functionality of stroke patients. The review was carried out by independent authors from July to October 2014. databases were consulted: LILACS, PEDRO, PUBMED and SCIELO. For the selection of manuscripts, we used the following key words: Neural Mobilization, Neurodynamics Mobilization, neurodynamic tests, stroke, spasticity Muscle, joint range of motion, flexibility and their counterparts in English. Studies were screened by reading the titles and objectives. Then deleted resumes in duplicate and performed the reading of articles to verify that met the inclusion criteria. Results: Six studies were selected, one being reviewed. In general, all the research has investigated the effects of NM in stroke patients. Four of the six articles were published in English. Only one study used a control group. As for treatment, there was divergence in relation to the NM application protocol. Conclusion: The reviewed studies indicate beneficial effects of neural mobilization in the control of muscle tone, range of motion and functionality of patients affected by stroke.

Combined Effect of Constraint Induced Movement Therapy and Neural Mobilization Technique on Upper Extremity Function in Spastic Hemiplegic Patient – A Single Case Study

“…Various research works suggested that elongation of peripheral nerves through Neuro muscular stretching were highly beneficial in Neuro rehabilitative measures for the patients with neuromuscular disorders by effectively employing neuro mobilization technique [10,11]. This suggestion corroborates with scientific studies which indicate the NM can be used in the prevention, assessment and treatment of neuromuscular disorders [11].…”

“…The significant changes in the outcome measures were shown after 20 weeks of prolonged intervention of combined constrained induced movement therapy and neural mobilization. That means in the prolonged chronic cases of spastic hemiplegia, there was minimum time period needed to gain physiological benefits in neuromuscular structures happened when the neural structures were benefitted by neuroplastic changes in the cerebral cortex neurons and nervous system as whole [11,21]. Numerous researches explained the attained benefits of constrained induced movement therapy and neural mobilizations separately.…”

“…Various research works suggested that elongation of peripheral nerves through Neuro muscular stretching were highly beneficial in Neuro rehabilitative measures for the patients with neuromuscular disorders by effectively employing neuro mobilization technique [10,11]. This suggestion corroborates with scientific studies which indicate the NM can be used in the prevention, assessment and treatment of neuromuscular disorders [11]. Neuro muscular techniques were very effective in reducing increased tone of the muscles, gaining muscle strength, better electrophysiological activity of nerves in the form of NCV and pain in animal subjects [12,13].…”

Effectiveness of Neurodynamic Interventions in Patients With Stroke: Protocol for a Systematic Review and Meta-analysis

“…A systematic review on neurodynamic techniques and mobilization in stroke rehabilitation finally included 12 studies (7 were RCTs, 3 quasi-experimental, 1 case report, and 1 systematic analysis) and concluded that there is limited evidence to support the use of NM techniques [ 4 ]. Another review on NM as a therapeutic option in the treatment of stroke included only 6 studies, and the results indicated beneficial effects of NM in the control of muscle tone, range of motion, and functionality of patients affected by stroke [ 14 ]. Previous studies on NM interventions on patients with stroke were limited to qualitative analysis, were not up to date, and had unclear or conflicting results [ 4 , 5 , 8 , 14 ].…”

“…Another review on NM as a therapeutic option in the treatment of stroke included only 6 studies, and the results indicated beneficial effects of NM in the control of muscle tone, range of motion, and functionality of patients affected by stroke [ 14 ]. Previous studies on NM interventions on patients with stroke were limited to qualitative analysis, were not up to date, and had unclear or conflicting results [ 4 , 5 , 8 , 14 ]. Due to the limited evidence and varying methodological quality, conclusions may change over time [ 5 ], and new RCTs are available in the literature.…”