In vivo longitudinal and transverse nerve excursion in response to joint movement in asymptomatic and symptomatic individuals: a systematic review

Abstract

Background Data on nerve excursion is crucial to inform clinical assessment and treatment using neurodynamic tests and neural mobilization. Objective To synthesize evidence on peripheral nerves longitudinal and transverse excursion in response to joint movement in both asymptomatic and symptomatic individuals and to determine whether there are significant differences between them. Methods Studies were sought using Pubmed, Physiotherapy Evidence Database (PEDro), Academic Search Complete, Scopus, ScienceDirect, Web of Science, and Scielo. Two reviewers independently screened titles and abstracts, assessed full reports, extracted information on studies’ characteristics, and assessed their methodological quality. A qualitative synthesis of data was performed. Results Thirty-one articles were included (19 on nerves of the upper limb and 12 on nerves of the lower limb), of which 21 reported on asymptomatic participants only and 10 compared symptomatic and asymptomatic participants. Longitudinal excursion in asymptomatic participants reached up to 50.2 mm and transverse excursion 4.3 mm. Eight (out of 10) studies found significant differences for nerve excursion between symptomatic and asymptomatic participants for diverse clinical conditions. Conclusion Nerve excursion varies in response to different combinations of joint movement, positioning of adjacent joints, distance to moving joint and nerve, and needs to be considered in neural testing and mobilization.