Upper Limb Neurodynamic Test of the Radial Nerve: A Study of Responses in Symptomatic and Asymptomatic Subjects

Abstract

Study Design Clinical measurement. Introduction Nonspecific cervical pain is a common clinical presentation. The role of upper limb neurodynamic tests (ULNT), for evaluation and treatment intervention, is not well defined for this population. Purpose of the Study This study's purpose was to determine if the radial-biased (RB)-ULNT discriminates any response differences between symptomatic subjects with a positive (+) RB-ULNT ( n = 36), symptomatic subjects with a negative (−) RB-ULNT ( n = 24), and asymptomatic subjects ( n = 60). Methods Sixty asymptomatic and 60 subjects presenting with nonspecific cervical and/or unilateral upper extremity pain were compared using the RB-ULNT. Symptomatic subjects were further divided in (+) and (−) RB-ULNT groups due to their response to the RB-ULNT. Within the symptomatic population, a positive response to the RB-ULNT was defined by the symptomatic subject reporting their sensations were increased with contralateral cervical lateral flexion and decreased with ipsilateral cervical lateral flexion. Sensation provocation and location were evaluated using the RB-ULNT in all the subjects during each stage of the testing. Results Significant differences on stage of reproduction and type of sensations were identified between 1) the (+) RB-ULNT symptomatic subjects, 2) the (−) RB-ULNT symptomatic subjects, and 3) the asymptomatic subjects. The (+) RB-ULNT group showed significantly increased pain responses during the first stage of the RB-ULNT compared with the (−) RB-ULNT group and the asymptomatic subjects. The (+) RB-ULNT also showed significantly decreased glenohumeral abduction passive range of motion when compared with the asymptomatic group. Conclusion Clinically, the differences found between the groups in their response to the RB-ULNT suggest heightened mechanosensitivity in the (+) RB-ULNT group. Level of Evidence 3a.