Neural gliding versus neural tensioning: Effects on heat and cold thresholds, pain thresholds and hand grip strength in asymptomatic individuals

Background: Although different types of neural mobilization (NM) exercises induce different amounts of longitudinal nerve excursion and strain, the question whether the increased longitudinal stress and nerve excursion from sliding or tensioning intervention may subtly affect the neural functions has not been answered yet. Objective: To compare the effects of tensioning NM versus sliding NM of the median nerve on peripheral and autonomic nervous system function. Methods: In this randomized controlled trial, 90 participants were randomly assigned to tensioning NM, sliding NM, or sham NM. The neurophysiological outcome measures included peak-to-peak amplitude of the dermatomal somatosensory evoked potential (DSSEP) for dermatomes C6, C7, C8, and T1. Secondary outcome measures included amplitude and latency of skin sympathetic response. All outcome measures were assessed pretreatment, immediately after the two weeks of treatment and one week after the last session of the treatment. Results: A 2-way repeated measures ANOVA revealed significant differences between the three groups. The post hoc analysis indicated that tensioning NM significantly decreased the dermatomal amplitude for C6, C7, C8, and T1 ([Formula: see text]). Sympathetic skin responses in the gliding NM group showed lower amplitudes and prolonged latencies post-treatment when compared to tensioning NM group ([Formula: see text]). In contrast, no significant changes were observed in the DSSEPs and skin sympathetic responses for participants in the sham treatment group ([Formula: see text]). Conclusions: A tensioning NM on the median nerve had a possible adverse effect on the neurophysiology variables of the nerves involved in the neural mobilization. Thus, tensioning NM with the current parameters that place increased stress and strain on the peripheral nervous system should be avoided.

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“… 39 Moreover, the majority of these comparisons were limited to measurement of pain, thermal, and mechanical sensitivity. 40 , 41 , 42 , 43 …”

Section: Discussionmentioning

confidence: 99%

Comparative effects of tensioning and sliding neural mobilization on peripheral and autonomic nervous system function: A randomized controlled trial

Alharmoodi

Arumugam

Ahbouch

et al. 2022

Hong Kong Physiother. J.

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“…Nerve tensioning involves executing joint motions that lengthen the nerve till symptoms develop and then mobilizing with the articular joint distal to where symptoms are thought to originate. Scholars say that the gliding technique provides less strain to the nerve than the tensioning technique, whereas nerve excursion is more in the gliding technique than in the tensioning technique without the potentially large increases in nerve strain [26].…”

Section: Treatment For Piriformis Syndromementioning

confidence: 99%

Physiotherapy for Piriformis Syndrome Using Sciatic Nerve Mobilization and Piriformis Release

Siraj¹,

Dadgal²

2022

Cureus

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Piriformis syndrome is also synonymous with sciatica or buttock pain. This is a condition where the muscle irritates the sciatic nerve. This nerve passes above, below, or in between the piriformis muscle piercing it. The muscle tightens or shortens, thus compressing the nerve and disturbing the impulses passing from it. The sciatic nerve is a combination of nerve roots from L4 to S3. Piriformis works as a lateral rotator and is a synergistic muscle of the flexor and abductor group. Females most commonly present with piriformis syndrome than males. Many causative factors are responsible for the compression or impingement of the sciatic nerve, one of which is piriformis syndrome. Tingling, numbness, and pain are most often felt by patients when they have compression of any of the nerves. Many physiotherapy techniques have been found to be effective in managing this problem. Techniques like nerve mobilization, stretching, myofascial release, deep friction massage, and many more have been studied by authors describing their effects in the treatment of piriformis syndrome. Neural mobilization consists of two techniques, nerve gliding and nerve tensioning. Studies have found that the gliding technique produces less strain on the nerve than the tensioning technique. Piriformis stretch reduces the tightening, which has caused the impingement. Two techniques have been used for this stretch, stretching with hip flexion over 90 degrees and hip flexion under 90 degrees. This review focuses on the different advances in treating piriformis syndrome.

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“…Therefore, five sets of 30 seconds were applied according to the author's suggestion and clinical experience. 27,28 However, the application sequence was set randomly. Computer-generated random numbers were used for randomization by an investigator.…”

Section: Interventionmentioning

confidence: 99%

Immediate Effects of Neural Slider and Neural Tensioner on Forward Bending in Subjects with Hamstring Tightness

Lim¹,

Lee²,

Kim³

2021

J Musculoskelet Sci Technol

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Neural gliding versus neural tensioning: Effects on heat and cold thresholds, pain thresholds and hand grip strength in asymptomatic individuals

Cited by 10 publications

References 35 publications

Comparative effects of tensioning and sliding neural mobilization on peripheral and autonomic nervous system function: A randomized controlled trial

Comparative effects of tensioning and sliding neural mobilization on peripheral and autonomic nervous system function: A randomized controlled trial

Physiotherapy for Piriformis Syndrome Using Sciatic Nerve Mobilization and Piriformis Release

Immediate Effects of Neural Slider and Neural Tensioner on Forward Bending in Subjects with Hamstring Tightness

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