Skip to Main Content

++

At the completion of this chapter, the reader will be able to:

++

  1. Summarize the various types of neurodynamic examination and mobilization techniques.

  2. Describe the proposed mechanisms behind the neurodynamic examination and mobilization techniques.

  3. Apply knowledge of the various neurodynamic mobilization techniques in the planning of a comprehensive rehabilitation program.

  4. Recognize the manifestations of abnormal nervous tissue tension and develop strategies using neurodynamic mobilization techniques to treat these abnormalities.

  5. Evaluate the effectiveness of a neurodynamic mobilization technique when used as a direct intervention.

++

Neurodynamics is the study of the mechanics and physiology of the nervous system. The nervous system is an electrical, chemical, and mechanical structure with continuity between its two subdivisions: the central and peripheral nervous systems (see Chapter 3). In addition to permitting inter- and intra-neural communication throughout the entire network, the nervous system is capable of withstanding mechanical stress as a result of its unique mechanical characteristics. Nervous tissue, a form of connective tissue, is viscoelastic. This viscoelasticity allows for the transfer of mechanical stress throughout the nervous system during trunk or limb movements. This adaptation results from changes in the length of the spinal cord1 and the capacity of the peripheral nerves to adapt to different positions. The peripheral nerves adapt through a process of passive movement relative to the surrounding tissue via a gliding apparatus around the nerve trunk.2,3 Three mechanisms appear to play an important role in this adaptability3:

++

  • Elongation of the nerve against elastic forces. In normal daily movement, nerves may slide up to 2 cm in relation to surrounding tissues and contend with a strain of 10%.4
  • Longitudinal movement of the nerve trunk in the longitudinal direction.
  • An increase and decrease of tissue relaxation at the level of the nerve trunk.

++

According to Millesi,3 the efficiency of this mechanism partially depends on the capacity of the loose connective tissue around the nerve (adventitia, conjunctiva nervorum, perineurium) to allow any traction forces to be distributed over the whole length of the nerve.3 If this distribution of forces is compromised, an unfavorable rise in traction forces can occur at certain segments, depending on the anatomic site (see next section).3

++

The role that tension on the neural tissue plays in pain and dysfunction has been studied for over a century. During this time, a number of specific tests have been designed to examine the neurological structures for the presence of adaptive shortening and inflammation.57 The more common of these neurodynamic mobility tests are described in this chapter.

++

The spinal dura (see Chapter 3) forms a loose sheath around the spinal cord from the foramen magnum to the level of the second sacral tubercle. From there it continues as the filum terminale to the end at the coccyx. Laterally, the dura surrounds the exiting spinal nerve roots at the level of ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

Create a Free MyAccess Profile

* Required Fields

Note: If you have registered for a MyAccess profile on any of the Access sites, you can use the same MyAccess login credentials across all sites.

Passwords must be between 6 and 40 characters long (no whitespace), cannot contain characters #, &, and must contain:
  • at least one lowercase letter
  • at least one uppercase letter
  • at least one digit

Benefits of a MyAccess Profile:

  • Remote access to the site off-campus on any device
  • Notification of new content via custom alerts
  • Bookmark your favorite content such as chapters, figures, tables, videos, cases and more
  • Save and download images to PowerPoint
  • Self-Assessment quizzes saved for quick review
  • Custom Curriculum access for both instructors and learners

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.