Comparing the immediate effects of different neural mobilization exercises on hamstring flexibility in recreational soccer players.

Background: Hamstring strain injuries remain a challenge for both athletes and clinicians given the high incidence rate, slow healing, and persistent symptoms. Increased tension in the neural structures is a known causative factor for hamstring tightness for which neural mobilization has emerged as a significant adjunct to routine stretching techniques. Objective: To compare the short-term effects of neural sliding and neural tensioning on hamstring length in male recreational soccer players with hamstring tightness. Methods: Sixty-two participants between ages 18 and 30 years were randomly assigned to one of the two groups viz. neural sliding or neural tensioning. Participants in either group performed the given stretching protocol in three sets. The Active Knee Extension Test (AKET) and Sit and Reach Test (SRT) were recorded before intervention, immediately after intervention, and after 60 min. between- and within group-analysis was done using analysis of variance. Results: Between-group analysis showed that neural tensioning was more effective than neural sliding in improving hamstring length on both measures, however this difference was negligible. Within-group analysis demonstrated that the mean post-test scores on the AKET test and SRT were significantly greater than the pre-test scores in both groups (p<0.05). A reduction in the post-test scores was observed after 60 min, irrespective of the type of stretching (p<0.05). Conclusion: There was no difference in short-term effects of neural sliding or neural tensioning on hamstring flexibility in male recreational soccer players. Both groups showed improved flexibility immediately after the intervention with reduction in the effect after 60 min.

Histological, immunohistochemical, and morphometric analysis of negative pressure-assisted in-vivo nerve stretch-growth.

Axons respond well to mechanical stimuli and can be stretched mechanically to increase their growth rate. Although stretch growth of axons and their transient lengthening ex-vivo has been discussed in literature extensively, however, real applications of this phenomenon are scarcely found. This work presents a technique to translate ex-vivo axonal stretch growth to in-vivo nerve stretch growth. By establishing a rat model of completely transected sciatic nerve injury, the regrowth rate of the proximal nerve stump was examined under the effect of a stretching force developed by negative pressure. In this manuscript, results have been presented based on quantitative and qualitative analysis of the stained nerve tissues. Gross observations have explicitly confirmed that the proximal stump of a whole sectioned sciatic nerve of a Wistar rat stretched in a T-shaped nerve prosthesis using a controlled amount of negative pressure displayed a better outcome in terms of an increase in the total length of proximal nerve stump post-treatment and a higher number of blood vessels with respect to control. The histological and morphometric analyses confirmed that negative pressure-assisted nerve growth provides an alluring control over nerve's regrowth rate. Immunohistochemical staining also supported the existence of a positive correlation between nerve growth and in-vivo application of axial stress on it. This work presents the first holistic evidence on growing nerves in the continuum of in-vivo nerve stretch growth using negative pressure and concludes that systematic and controlled negative pressure applied directly to the resected ends of a sciatic nerve resulted in the enhanced growth rate of regenerating nerve fibres.

Design and fabrication of a nerve-stretching device for in vivo mechanotransduction of peripheral nerve fibers.

The potential of peripheral nerves to regenerate under the effect of axial tensile forces was not previously extensively explored due to the lack of capabilities of translating ex vivo axonal stretch-growth to in vivo studies, until the development of a nerve stretcher. The nerve stretcher, which we have designed and manufactured recently, is a device that uses a controlled amount of axial tensile force (vacuum/negative gauge pressure) applied directly to a sectioned peripheral nerve in vivo to expedite nerve regrowth rate. Using this platform, a series of experiments was carried out to observe the effect of in vivo axial stretch on axonal lengthening. During these experiments, a few challenges necessitated redesigning the device like a sudden loss of stretching force due to vacuum leakage, erroneous feedback from vacuum sensor due to sensor drift, and inability to control and operate the device remotely. Here we present an improved design of the nerve stretcher along with its integration with a state-of-the-art online vacuum monitoring facility to control, collect, process, and visualize negative gauge pressure data in real-time.

Nerve-stretching in the 19th century.

Operative nerve-stretching was first described in 1872 to relieve incurable pain from sciatica and tabes dorsalis. It became popular for 20 years and numerous articles were published on the subject. It had many complications but relief was only transient and, consequently, it fell into disuse. This paper analyses the literature, contemporary views on the benefits of nerve stretching and its influence on more recent neurological practice.

Facilitation of Motor Evoked Potential by Stretching of Peripheral Nerve

OBJECTIVE: To investigate the effect of peripheral nerve stretching on motor evoked potentials (MEP) as a method of facilitation. METHODS: Twenty three normal healthy volunteers were enrolled. Transcranial magnetic stimu lation (TMS) was applied to the contralateral scalp at 7 cm lateral to Cz using 90 cm round coil. Intensity of stimulation was adjusted to 90% of maximal stimulation intensity. Recording was done on the abductor pollicis brevis muscle in three different conditions; firstly resting state, secondly voluntary contraction of abductor pollicis brevis muscle, and lastly with stretching of median nerve. The onset latency and amplitude were obtained and compared between three conditions. RESULT: The amplitude of MEP was significantly increased in the condition with muscle contraction and peripheal nerve stretching compared with resting state. The latency was shortened in the condition with muscle contraction with statistical significance and with peripheral nerve stretching without significance. CONCLUSION: We concluded that stretching of peripheral nerve can be used as a method of facilitation of MEP. This method is considered to be useful especially for the patients with motor paralysis or poor cooperarion for voluntary contraction.