The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect of Rhythmic Neurodynamic on the Upper Extremity Nerve Conduction Velocity and the Function for Stroke Patients

  • Received : 2017.07.05
  • Accepted : 2017.08.22
  • Published : 2017.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to resolve, in an efficient manner, the mechanoreceptor problems of the part far from the paretic upper extremity in stroke patients, as well as to provide clinical basic data of an intervention program for efficient neurodynamic in stroke patients, by developing a rhythmic neurodynamic exercise program and verifying functional changes depending on the increase in the upper extremity nerve conduction velocity. Methods: Samples were extracted from 18 patients with hemiplegia, caused by stroke, and were randomly assigned to either the experimental group I for the general upper extremity neurodynamic (n=9) and the experimental group II for rhythmic upper extremity neurodynamic (n=9). An intervention program was applied ten times per set (three sets one time) and four times a week for two weeks (once a day). As a pre-test, changes in the upper extremity nerve conduction velocity and functions were assessed, and two weeks later, a post-test was conducted to re-measure them in the same manner. Results: The wrist and palm sections of the radial nerve and the wrist and elbow sections of the median nerve, as well as the wrist, lower elbow, upper elbow, and axilla sections of the ulnar nerve had significant differences with respect to the upper extremity nerve conduction velocity between the two groups (p<0.05)(p<0.01), and significant differences were also found in the upper extremity functions (p<0.05). Conclusion: Rhythmic neurodynamic accelerated the nerve conduction velocity more in broader neural sections than the general neurodynamic. In conclusion, rhythmic neurodynamic was proven to be effective for improving the functions of upper extremity.

Keywords

References

  1. Kim CB, Choi JD. Comparison of pulmonary and gait function in subacute or chronic stroke patients and healthy subjects. J Kor Soc Phys Ther. 2011;23(5):23-8.
  2. Carter AR, Connor LT, Dromerick AW. Rehabilitation after stroke: current state of the science. Curr Neurol Neurosci Rep. 2010;10(3):158-66. https://doi.org/10.1007/s11910-010-0091-9
  3. Beebe JA, Lang CE. Active range of motion predicts upper extremity function 3 months after stroke. Stroke. 2009;40(5):1772-9. https://doi.org/10.1161/STROKEAHA.108.536763
  4. Dobkin BH. Strategies for stroke rehabilitation. Lancet Neurol. 2004;3(9):528-36. https://doi.org/10.1016/S1474-4422(04)00851-8
  5. Fujiwara T, Kawakami M, Honaga K et al. Hybrid assistive neuromuscular dynamic stimulation therapy: a new strategy for improving upper extremity function in patients with hemiparesis following stroke. Neural Plast. 2017;2017:2350137.
  6. Kim BY, Choi WH. The effects of interferential cuttent therapy on spasticity, range of motion, and balance ability in stroke patient. J Kor Soc Phys Ther. 2013;25(4):187-94.
  7. Spaans F, Wilts G. Denervation due to lesions of the central nervous system: an EMG study in cases of cerebral contusion and cerebrovascular accidents. J Neurol Sci. 1982;57(2):291-305. https://doi.org/10.1016/0022-510X(82)90036-3
  8. Andersen H, Gjerstad MD, Jakobsen J. Atrophy of foot muscles. Diabetes Care. 2004;27(10):2382-5. https://doi.org/10.2337/diacare.27.10.2382
  9. Castilho J, Ferreira LA, Pereira WM et al. Analysis of electromyographic activity in spastic biceps brachii muscle following neural mobilization. J Bodyw Mov Ther. 2012;16(3);364-8. https://doi.org/10.1016/j.jbmt.2011.12.003
  10. Kumar KV, Joshua AM, Kedambadi R et al. Eclectic/mixed model method for upper extremity functional recovery in stroke rehabilitation: a pilot study. J Nat Sci Biol Med. 2017;8(1):75-81. https://doi.org/10.4103/0976-9668.198357
  11. de Oliverira Junior HF, Teixeira AH. Mobilizacao do sistema nervoso: avaliacao e tratamento. Fisioter mov. 2007;20(3):41-53.
  12. Maitland GD. The slump test: examination and treatment. Aust J Physiother. 1985;31(6);215-9. https://doi.org/10.1016/S0004-9514(14)60634-6
  13. Jung YW, Seo HK, Kim BG et al. The effect of neural mobilization on the grip strength. J Kor Phys Ther. 2004;16(4):226-34.
  14. Kim JH, Yuk GC, Bae SS. Nurobiology and neurobiomechanics for neural mobilization. J Kor Soc Phys Ther. 2003;15(2):67-74.
  15. Nery dos Santos AC, Gusmao de Goes AC, Lago RMV et al. Neural mobilization as a therapeutic option in the treatment of stroke. Man Ther. 2016;14(310):1-4.
  16. de Lima KCS, Piauilino PMM, Franco RM et al. Effect of muscle stretching, neural mobilization and vibration in patients with stroke. ConScientiae Saude. 2061;15(1):62-70.
  17. Godoi J, Kerppers II, Rossi LP et al. Electromyographic analysis of biceps brachii muscle following neural mobilization in patients with stroke. Electromyogr Clin Neurophysiol. 2010;50(1):55-60.
  18. Kim YJ, Kim TY, Kim SY et al. Comparison the initial effects of nerve mobilization techniques, static stretching and contract-relax on hamstring flexibility and walking ability in post-stroke hemiplegia patients. J Korean Soc Phys Med. 2011;6(4):369-79.
  19. Boyd BS, Wanek L, Gray AT et al. Mechanosensitivity during lower extremity neurodynamic testing is diminished in individuals with type 2 diabetes mellitus and peripheral neuropathy: a cross sectional study. BMC Neurol. 2010;10(1):1-14. https://doi.org/10.1186/1471-2377-10-1
  20. Robson N, Faller II KJ, Ahir V et al. Creating a virtual Perception for upper limb rehabilitation. Stroke. 2017;11(4):152-7.
  21. Ha MS. The effects of median nerve self-mobilization on shoulder depression and wrist extension. Silla University. Dissertation of Master's Degree. 2013.
  22. Nakamura R, Moriyama S. Rehabilitation manual 8: manual function test (MFT) and functional occupational therapy for stroke patients. Tokorozawa, National rehabilitation center for the Disabled, 2000.
  23. Lang CE, Bland MD, Bailey RR et al. Assessment of upper extremity impairment, function, and activity after stroke: foundations for clinical decision making. J Hand Ther. 2013;26(2):104-14. https://doi.org/10.1016/j.jht.2012.06.005
  24. Nee RJ, Butler D. Management of peripheral neuropathic pain: integrating neurobiology, neurodynamics, and clinical evidence. Phys Ther Sport. 2006;7(1):36-49. https://doi.org/10.1016/j.ptsp.2005.10.002
  25. Namba T, Schuman MH, Grob D. Conduction velocity in the ulnar nerve in hemiplegic patients. J Neurol Sci. 1971;12(2);177-86. https://doi.org/10.1016/0022-510X(71)90048-7
  26. Lee CR, Son GS, Lee SY et al. Effects of nerve mobilization on the spasticity of ankle plantar flexor muscles in stroke patients. J Kor Phys Ther. 2007;19(1):79-90.
  27. Wolny T, Saulicz E, Mysliwiec A et al. Effectiveness of neuromobilisation in upper limb discriminatory sense rehabilitation in late-stage poststroke patients. Physikalische Medizin. 2014;24(1):42-7.
  28. Kan P, Huq R, Hoey J et al. The development of an adaptive upper-limb stroke rehabilitation robotic system. J Neuroeng Rehabil. 2011;8(1):1-18. https://doi.org/10.1186/1743-0003-8-1
  29. Rosales RL, Kanovsky P, Fernandez HH. What's the "catch" in upperlimb post-stroke spasticity: expanding the role of botulinum toxin applications. Parkinsonism Relat Disord. 2011;17(1):3-10. https://doi.org/10.1016/j.parkreldis.2011.06.019
  30. Villafane JH, Silva GB, Chiarotto A et al. Botulinum toxin type a combined with neurodynamic mobilization for upper limb spasticity after stroke: a case report. J Chiropr Med. 2012;11(3): 186-91. https://doi.org/10.1016/j.jcm.2012.05.009
  31. Pack JW. The effect of the upper limb soft tissue and nerve mobilization on functional recovery in hemiplegic patients after CVA. Daegu University. Dissertation of Master's Degree. 2001
  32. Scott M, Taylor S, Chesterton P et al. Motor imagery during action observation increases eccentric hamstring force: an acute non-physical intervention. Disabil Rehabil. 2017;21:1-9.
  33. Kang JI, Moon YJ, Choi H et al. The effect of exercise types for rotator cuff repair patients on activities of shoulder muscles and upper limb disability. J Phy Ther Sci. 2016;28(10):2772-7. https://doi.org/10.1589/jpts.28.2772

Cited by

  1. Muscle activity in relation to the changes in peripheral nerve conduction velocity in stroke patients: Focus on the dynamic neural mobilization technique vol.9, pp.2, 2017, https://doi.org/10.20540/jiaptr.2018.9.2.1447