The Effect of Neurodynamic Techniques on the Dispersion of Intraneural Edema: A Systematic Review with Meta-Analysis

Abstract

Background: There is evidence for the positive effects of neurodynamic techniques in some peripheral entrapment neuropathies, but the rationale for these effects has not been validated. We aimed to estimate the direct effect of neurodynamic techniques on the dispersion of artificially induced intraneural edema measured by dye spread in cadavers. Methods: We systematically searched the MEDLINE, WOS, Scopus, and the Cochrane databases from inception to February 2020 for experimental studies addressing the efficacy of neurodynamic techniques on the dispersion of artificially induced intraneural edema. The DerSimonian and Laird method was used to compute pooled estimates of the mean differences (MDs) and its respective 95% confidence intervals (CIs). Subgroup analyses were conducted according to the type of neurodynamic technique. In addition, a 95% prediction interval was calculated to reflect the variation in true treatment effects in different settings, including the effect to be expected in future patients. Results: Pooled results showed a significant increase in fluid dispersion (MD = 2.57 mm; 95%CI: 1.13 to 4.01). Subgroup analysis showed increased dye spread in the tensioning techniques group (MD = 2.22 mm; 95%CI: 0.86 to 3.57). Conclusion: Neurodynamic techniques improved the intraneural edema dispersion and should be considered for the management of peripheral compression neuropathies. Furthermore, tensioning techniques appear to be effective in helping to disperse intraneural edema.

Exercise intervention for the management of chemotherapy-induced peripheral neuropathy: A systematic review and network meta-analysis

“…Our analysis with updated trials indicated that exercise positively affected QOL, consistent with previous systematic reviews that showed that exercise resulted in an improvement in QOL scores (SMD: 14.62, 95% CI, 6.03-3.20) (19,43). A similar meta-analysis of studies on the severity of CIPN and peripheral deep sensitivity showed positive results, as in our research on QOL (44).…”

Short‐term effectiveness of kinesio taping as therapeutic tool in conservative treatment of carpal tunnel syndrome: A systematic review and meta‐analysis

“…Therefore, kinesio taping appears to be a valid and recommended intervention complementary to other therapies to obtain greater effectiveness rather than a stand-alone therapy in patients with CTS. Some of these conventional therapies comprise neurodynamic techniques for decreasing pain and functionality (de Arenas-Arroyo et al, 2021), shock waves for functionality (with contradictory outcomes for pain at present) (Chen et al, 2022;Xie et al, 2020), the use of splints to improve functionality, severity, and the neurophysiological aspects studied in this pathology (Karjalainen et al, 2023).…”

“…Among the options for treating this syndrome, conservative treatment is recommended for mild and moderate cases while surgery is the main choice for severe cases (Huisstede et al, 2014) of patients presenting reduced fine motor coordination, clumsiness, thenar atrophy, and severe sensitivity loss (Genova et al, 2020). The most used techniques among conservative treatments are manual therapy (weak evidence) (Erickson et al, 2019;Gräf et al, 2022;Hernández-Secorún et al, 2021), neurodynamic techinques (de Arenas-Arroyo et al, 2021), electrotherapy (Hernández-Secorún et al, 2021), and pharmacological treatment (de Pablo & Katz, 2003;Hernández-Secorún et al, 2021), which can be complemented with other interventions such as shock waves (Chen et al, 2022;Huisstede et al, 2018;Karjalanen et al, 2022;Xie et al, 2020), myofascial massage to active myofascial points (Huisstede et al, 2018), splints (Huisstede et al, 2018;Karjalanen et al, 2022), ultrasound (Huisstede et al, 2018;Karjalanen et al, 2022), microwaves (Huisstede et al, 2018), or pulsed radiofrequency (Huisstede et al, 2018), obtaining superior results with the joint application of these techniques (Talebi et al, 2018).…”

Effectiveness of prevention exercises protocol among office workers with symptoms of carpal tunnel syndrome

“…In contrast, for those with mild to moderate symptoms of CTS, it appears that the use of stretching exercises to mobilize upper limb structures may be a simple and effective method used as a preventive measure for those at risk of developing compression neuropathy [29,30].…”