Abstract：
Neurodynamic tests are an essential aspect of the physical examination of the patient when suspicion of neural involvement exists. A manoeuvre that is hypothesised to move nerves differentially relative to other structures (structural differentiation) has been proposed as a necessary part of neurodynamic testing for differential diagnosis. However, although the specificity of structural differentiation for peripheral nerve over muscle has been demonstrated in some body regions, no study has tested specificity of nerve movement relative to fascia.
The aim of this study was to measure the effect of the cervical contralateral lateral flexion (CCLF) as an structural differentiation manoeuvre for the median nerve compared to fascia (superficial and deep) at the wrist during the upper limb neurodynamic test 1 (ULNT1).
A cross-sectional study was performed in 5 fresh frozen cadavers.
Excursion and strain in the fascia (superficial and deep) and the median nerve were measured at the wrist with structural differentiation during the ULNT1. KINOVEA software was used to measure kinematic parameters.
CCLF resulted in significant proximal excursion in the median nerve (p < 0.001*) but not in the strain. CCLF neither produced changes in strain nor excursion in the superficial and deep fascia (p > 0.05).
This study showed that CCLF produced significant differential excursion in the median nerve at the wrist compared to the local superficial and deep fascia during the ULNT1. The data support CCLF in mechanical differentiation between nerve and fascia in this area in diagnosis of local sources of wrist pain.
The aim of this study was to measure the effect of the cervical contralateral lateral flexion (CCLF) as an structural differentiation manoeuvre for the median nerve compared to fascia (superficial and deep) at the wrist during the upper limb neurodynamic test 1 (ULNT1).
A cross-sectional study was performed in 5 fresh frozen cadavers.
Excursion and strain in the fascia (superficial and deep) and the median nerve were measured at the wrist with structural differentiation during the ULNT1. KINOVEA software was used to measure kinematic parameters.
CCLF resulted in significant proximal excursion in the median nerve (p < 0.001*) but not in the strain. CCLF neither produced changes in strain nor excursion in the superficial and deep fascia (p > 0.05).
This study showed that CCLF produced significant differential excursion in the median nerve at the wrist compared to the local superficial and deep fascia during the ULNT1. The data support CCLF in mechanical differentiation between nerve and fascia in this area in diagnosis of local sources of wrist pain.
摘要：
背景：当怀疑存在神经受累时，神经动力学测试是对患者进行身体检查的重要方面。已经提出了一种假设相对于其他结构差异地移动神经的动作（结构差异），作为用于鉴别诊断的神经动力学测试的必要部分。然而,尽管在某些身体区域已经证明了周围神经在肌肉上的结构分化的特异性，没有研究测试相对于筋膜的神经运动的特异性。
目的：本研究的目的是在上肢神经动力学测试1（ULNT1）期间，测量颈椎对侧侧侧屈（CCLF）作为正中神经与腕部筋膜（浅层和深层）相比的结构分化动作的效果。
方法：对5具新鲜冷冻尸体进行了横断面研究。
方法：在ULNT1期间，在腕部测量筋膜（浅层和深层）和正中神经的偏移和应变，并具有结构分化。使用KINOVEA软件测量运动学参数。
结果：CCLF导致正中神经的显著近端偏移（p<0.001*），但不导致应变。CCLF在浅筋膜和深筋膜中均未产生应变或偏移的变化（p>0.05）。
结论：这项研究表明，与ULNT1期间的局部浅层和深筋膜相比，CCLF在腕部正中神经产生了明显的差异偏移。数据支持CCLF在该区域的神经和筋膜之间的机械区分，以诊断腕关节疼痛的局部来源。
目的：本研究的目的是在上肢神经动力学测试1（ULNT1）期间，测量颈椎对侧侧侧屈（CCLF）作为正中神经与腕部筋膜（浅层和深层）相比的结构分化动作的效果。
方法：对5具新鲜冷冻尸体进行了横断面研究。
方法：在ULNT1期间，在腕部测量筋膜（浅层和深层）和正中神经的偏移和应变，并具有结构分化。使用KINOVEA软件测量运动学参数。
结果：CCLF导致正中神经的显著近端偏移（p<0.001*），但不导致应变。CCLF在浅筋膜和深筋膜中均未产生应变或偏移的变化（p>0.05）。
结论：这项研究表明，与ULNT1期间的局部浅层和深筋膜相比，CCLF在腕部正中神经产生了明显的差异偏移。数据支持CCLF在该区域的神经和筋膜之间的机械区分，以诊断腕关节疼痛的局部来源。
