Noninvasive Measurement of Sciatic Nerve Stiffness in Patients With Chronic Low Back Related Leg Pain Using Shear Wave Elastography

Neto, Tiago; Freitas, Sandro R.; Andrade, Ricardo J.; Vaz, João R.; Mendes, Bruno; Firmino, Telmo; Bruno, Paula M.; Nordez, Antoine; Oliveira, Raúl

doi:10.1002/jum.14679

Cited by 18 publications

(44 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is a growing body of evidence of in-vivo studies supporting that mechanical properties of human peripheral nerves are altered in various peripheral neuropathies, such as those associated with nerve compression [60], metabolic syndrome [61], and radiculopathies [62][63][64]. Interestingly, a preliminary study reported that a 3-min slump (static) stretch resulted in an immediate decrease in sciatic nerve stiffness in people with unilateral sciatica [65].…”

Section: Evidence From Human Trialsmentioning

confidence: 99%

Neurodynamics: is tension contentious?

Ellis

Carta

Andrade

et al. 2021

Journal of Manual & Manipulative Therapy

Self Cite

View full text Add to dashboard Cite

Tensioning techniqueswere the first neurodynamic techniques used therapeutically in the management of people with neuropathies. This article aims to provide a balanced evidenceinformed view on the effects of optimal tensile loading on peripheral nerves and the use of tensioning techniques. Whilst the early use of neurodynamics was centered within a mechanical paradigm, research into the working mechanisms of tensioning techniques revealed neuroimmune, neurophysiological, and neurochemical effects. In-vitro and ex-vivo research confirms that tensile loading is required for mechanical adaptation of healthy and healing neurons and nerves. Moreover, elimination of tensile load can have detrimental effects on the nervous system. Beneficial effects of tensile loading and tensioning techniques, contributing to restored homeostasis at the entrapment site, dorsal root ganglia and spinal cord, include neuronal cell differentiation, neurite outgrowth and orientation, increased endogenous opioid receptors, reduced fibrosis and intraneural scar formation, improved nerve regeneration and remyelination, increased muscle power and locomotion, less mechanical and thermal hyperalgesia and allodynia, and improved conditioned pain modulation. However, animal and cellular models also show that 'excessive' tensile forces have negative effects on the nervous system. Although robust and designed to withstand mechanical load, the nervous system is equally a delicate system. Mechanical loads that can be easily handled by a healthy nervous system, may be sufficient to aggravate clinical symptoms in patients. This paper aims to contribute to a more balanced view regarding the use of neurodynamics and more specifically tensioning techniques.

show abstract

Section: Evidence From Human Trialsmentioning

confidence: 99%

Neurodynamics: is tension contentious?

Ellis

Carta

Andrade

et al. 2021

Journal of Manual & Manipulative Therapy

Self Cite

View full text Add to dashboard Cite

show abstract

“…The shear wave features were presented in different conditions and diseases, respectively in healthy patients. Neto et al [26] presented higher sciatic nerve stiffness compared to the unaffected limb (8.2 to 16.2m/sec and 9 to 13.6m/sec, P=.05) in patients with chronic low back leg pain. The resistance (shear-wave technique) in dynamic and unresisting knee extension was observed by Ellis [17].…”

Section: Resultsmentioning

confidence: 92%

The Role of the Sciatic Nerve Ultrasound Elastography in the Clinical Pathway: A Meta-analysis

2020

Arch Orthop

View full text Add to dashboard Cite

Over the last few years, more papers were published related to the usefulness of sciatic nerve ultrasound elastography in clinical practice. Ultrasound elastography is a diagnostic method, to measure elasticity and strain in tissues and organs. The aim of this review was to highlight the usefulness of sciatic nerve ultrasound elastography in clinical practice, strictly compared with electromyography and MRI findings. Sonoelastographic evaluation was performed predominantly in patients with deep gluteal syndrome (DGS). The results were processed by meta-analysis. In this review, in the final processing, 16 studies were identified, 4 with strain ratio, 12 with shear wave elastography. The data was collected in a timeframe of 2013 to 2019. Looking at the reviewed studies, different techniques were applied (quasi-static, ARFI and shear wave elastography), with various joint movements, several "region of interest", non-standardized measurement units and patients with dissimilar pathologies. The review summary leads to conclude that sciatic nerve ultrasound elastography test is not well clinically standardized. The nerve and surrounding muscles have to be assessed by color scale and B mode. Determining strain index may be useful, on particular equipment and within the same institution. The shear wave technique provides us with more secure and direct results, comparable to those of other institutions and researchers. This method is the most proven for deep gluteal syndrome with a wide range of manifestations, unilateral lumbar disc hernia, the assessment of sports injuries, to study musculoskeletal activity, monitoring the course of rehabilitation and in monitoring postoperative recovery.

show abstract

“…However, there is limited understanding of the effects of nerve tension on SW velocity because this has never been studied in two nerves of the same limb. Previous reports have only individually analyzed the median, tibial, and sciatic nerves. In addition, the interactive effects of extrinsic and intrinsic factors, such as nerve tension and structure/composition, on SW velocity remain to be determined.…”

Section: Introductionmentioning

confidence: 99%

Influence of limb position on assessment of nerve mechanical properties by using shear wave ultrasound elastography

2020

View full text Add to dashboard Cite

Introduction: Evaluation of nerve mechanical properties has the potential to improve assessment of nerve impairment. Shear wave velocity, as measured by using shear wave (SW) ultrasound elastography, is a promising indicator of nerve mechanical properties such as stiffness. However, elucidation of external factors that influence SW velocity, particularly nerve tension, is required for accurate interpretations.Methods: Median and ulnar nerve SW velocities were measured at proximal and distal locations with limb positions that indirectly altered nerve tension.Results: Shear wave velocity was greater at proximal and distal locations for limb positions that induced greater tension in the median (mean increase proximal 89.3%, distal 64%) and ulnar (mean increase proximal 91.1%, distal 37.4%) nerves.Discussion: Due to the influence of nerve tension when SW ultrasound elastography is used, careful consideration must be given to limb positioning. K E Y W O R D S mechanical properties, nerve cross-sectional area, neuromuscular ultrasound, peripheral nerve, shear wave ultrasound elastography, tension

show abstract

Noninvasive Measurement of Sciatic Nerve Stiffness in Patients With Chronic Low Back Related Leg Pain Using Shear Wave Elastography

Cited by 18 publications

References 21 publications

Neurodynamics: is tension contentious?

Neurodynamics: is tension contentious?

The Role of the Sciatic Nerve Ultrasound Elastography in the Clinical Pathway: A Meta-analysis

Influence of limb position on assessment of nerve mechanical properties by using shear wave ultrasound elastography

Contact Info

Product

Resources

About