Negative Neurodynamic Tests Do Not Exclude Neural Dysfunction in Patients With Entrapment Neuropathies.
Arch Phys Med Rehabil
; 98(3): 480-486, 2017 03.
Article
en En
| MEDLINE
| ID: mdl-27449322
ABSTRACT
OBJECTIVE:
To examine differences in somatosensory phenotypes of patients with positive and negative neurodynamic tests and compare these with healthy participants.DESIGN:
Case-control study.SETTING:
University department.PARTICIPANTS:
Patients with electrodiagnostically confirmed carpal tunnel syndrome (CTS) (n=53) and people without CTS (n=26) participated in this study (N=79). Patients with CTS were subgrouped according to the results of the upper limb neurodynamic tests biasing the median nerve into patients with positive or negative neurodynamic tests.INTERVENTIONS:
Not applicable. MAIN OUTCOMEMEASURE:
All participants underwent quantitative sensory testing in the median innervated territory of their hand.RESULTS:
Only 46% of patients with CTS had positive neurodynamic tests. No differences were identified between groups for pain thresholds (P>.247). However, patients with CTS had increased mechanical (P<.0001) and thermal detection thresholds (P<.0001) compared with people without CTS. Patients with negative neurodynamic tests had a more pronounced vibration detection deficit (mean, 7.43±0.59) than people without CTS (mean, 7.89±0.22; P=.001). Interestingly, warm detection was the only domain differentiating positive (mean, 4.03°C±2.18°C) and negative neurodynamic test groups (6.09°C±3.70°C, P=.032), with patients with negative neurodynamic tests demonstrating increased loss of function.CONCLUSIONS:
Patients with negative neurodynamic tests seem to have a more severe dysfunction of the unmyelinated fiber population. Our findings suggest that neurodynamic tests should not be used in isolation to judge neural involvement. Rather, they should be interpreted in the context of loss of function tests of the small fiber domain.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Síndrome del Túnel Carpiano
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Modalidades de Fisioterapia
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Nervio Mediano
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Examen Neurológico
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Arch Phys Med Rehabil
Año:
2017
Tipo del documento:
Article
País de afiliación:
Suiza