Peripheral Nerve Glides
Neurophysiological Funcation
- Normal function requires aqueduct movement.
- Nerve tissues need ample amount of circulation to function.
- The neuron requires approximately 30% of all the oxygen pumped from the heart making it tissue oxygen dependent
- Axoplasm is the cytoplasm of the nerve cell. Its function is to carry ion channels and neurotransmitters to the cell member as well as cytoskeletal proteins to main the health of the nerve.
- The ion channels open and close due to sensitivity and the type of ion channels opening and closing. An ion channel only lives for approximately two days
Rational and Facts
- These techniques are used to improve the mechanical, electrical, and chemical properties of nerve tissue.
- These can be implemented for both acute and chronic nerve issues in the upper and lower body.
- Butler targeted the main tracks of the upper extremity by creating the Upper Limb Neurological Tests (ULNT)
- These motions can be applied to improve the overall health of nerve tissue as it travels from the cervical root distally.
- A single peripheral nerve can be stretched up to 8% of its normal resting length before ischemia occurs.
- These nerve tissues are extremely strong because of the high percentage of connective tissue making up the nerve.
Median Nerve Test (ULNT 1)
This test initiates shoulder abduction, wrist and finger extension, forearm supination, shoulder external rotation, and elbow extension. Shoulder depression is applied to increase tension upon the plexus, nerve roots, and nerve track. Cervical lateral flexion increases or decreases the amount of tension being placed on the system (lateral flexion toward testing arm decreases tension; away from testing arm increases tension).
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Radial Nerve Test (ULNT 2B)
The test initiates shoulder depression, elbow extension, shoulder internal rotation, wrist and thumb flexion, and shoulder abduction. Shoulder abduction or cervical lateral flexion increases or decreases the amount of tension being placed on the nerve (lateral flexion toward testing arm decreases tension; away from testing arm increases tension. Increase in shoulder abduction increases tension; less shoulder abduction decreases tension).
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Ulnar Nerve Test (ULNT 3)
The test initiates shoulder depression, shoulder external rotation, shoulder abduction, elbow flexion, forearm pronation, and wrist extension. Shoulder depression or cervical lateral flexion increases or decreases the amount of tension being placed on the nerve (lateral flexion toward testing arm decreases tension; away from testing arm increases tension. Increase in shoulder depression increases tension; less shoulder depression decreases tension).
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Neurodynamics with Rehab
- Functional tests can also be used as a therapeutic intervention
- Each rehab visit should begin with them to "warm-up" the neurological system
- This improves the ability of the nervous system to handle "the load" of athletic/normal movement
- Opportunity to change the sensitivity of ion channels to help decrease pain
- Improve circulation to the axons (increasing oxygen and nutrient delivery)
- Decreases the viscosity of the axonplasm making it easier to move through and around the axon
- Repetitions of the Neural glides
- 3 sets of 20-30 repetitions to each side
- Pattern should begin with small, pain free range of motion before progressing into greater range of motion. Patient discomfort should be used as a guide