Asymmetry of the ULNT1 elbow extension range-of-motion in a healthy population: Consequences for clinical practice and research

作者：Van Hoof Tom^*; Vangestel Carl; Shacklock Michael; Kerckaert Ingrid; D' Herde Katharina

来源：Physical Therapy in Sport, 2012, 13(3): 141-149.

DOI：10.1016/j.ptsp.2011.09.003

• ULNT1
• Neurodynamic testing
• ROM
• Hand dominance
• Langer%26apos
• s axillary arch

Objectives: To investigate the effect of isolated muscular variance, side and hand dominance on elbow-extension range-of-motion (EE-ROM) of the median nerve upper limb neurodynamic test (ULNT1). This study analyzes these variables potential to influence ULNT1 EE-ROM symmetry and the possible consequences for clinical practice and research. %26lt;br%26gt;Study design: Controlled laboratory study, cross-sectional. %26lt;br%26gt;Background: No normative data exist to interpret correctly EE-ROM. Clinical interpretation is based on bilateral comparison. This procedure assumes natural EE-ROM symmetry, with lack of scientific evidence. %26lt;br%26gt;Methods: Nineteen participants with Langer%26apos;s axillary arch (LAA), a muscular variant bridging the brachial plexus, were selected from 640 healthy volunteers, together with a matched control group. ULNT1 EE-ROM%26apos;s were measured using the Vicon (R) optoelectronic system. %26lt;br%26gt;Results: A full mixed model revealed no significant effects on EE-ROM for LAA and the variable side. Significant differences were found in EE-ROM between dominant and non-dominant sides (standard ULNT1 test position: 2.84 degrees +/- 1.60 degrees, p = 0.0004: ULNT1 with differentiating maneuver: 3.05 degrees +/- 1.98 degrees, p = 0.003). Approximately 30% of the subjects showed clinically detectable restriction (%26gt;= 10 degrees) of the dominant side EE-ROM. %26lt;br%26gt;Conclusion: Hand dominance is significantly associated with restriction of EE-ROM, which results in a clinically detectable asymmetry. This compromises the clinical procedure of comparing the patient%26apos;s EE-ROM to the opposite side. Erroneous conclusions could result in side to side analyses, if the effect is not taken into account in neurodynamic research.

• 出版日期2012-8