Effectiveness of physiotherapy in different sensory disturbances in selected peripheral neuropathies

Intervention group (neurodynamic techniques) - gliding and tension neurodynamic techniques of peripheral nerve (upper limb, lower limb), one-direction proximal and distal glide mobilisation and one-direction proximal and distal tension mobilisation. Upper limb: a. medial nerve – position supine, neurodynamic sequence: arm adduction 90 degree and external rotation, wrist and finger extension, forearm supination, elbow extension; one-direction proximal glide mobilisation (movement – elbow extension –large amplitude of motion), one-direction distal glide mobilisation (movement – wrist extension –large amplitude of motion), one-direction proximal tension mobilisation (movement – elbow extension –small amplitude of motion et the end of the movement), one-direction distal tension mobilisation (movement – wrist extension – small amplitude of motion et the end of the movement) b. ulnar nerve - position supine, neurodynamic sequence: wrist and finger extension, forearm pronation, arm external rotation, elbow flection, arm adduction; one-direction proximal glide mobilisation (movement – arm adduction –large amplitude of motion), one-direction distal glide mobilisation (movement – wrist extension –large amplitude of motion), one-direction proximal tension mobilisation (movement – arm adduction –small amplitude of motion et the end of the movement), one-direction distal tension mobilisation (movement – wrist extension – small amplitude of motion et the end of the movement) c. radial nerve – position supine, neurodynamic sequence: elbow extension, arm interial rotation, wrist flexion, arm adduction and extension; one-direction proximal glide mobilisation (movement – elbow extension –large amplitude of motion), one-direction distal glide mobilisation (movement – wrist flexion –large amplitude of motion), one-direction proximal tension mobilisation (movement – elbow extension –small amplitude of motion et the end of the movement), one-direction distal tension mobilisation (movement – wrist flexion – small amplitude of motion et the end of the movement) Lower limb: a. tibial nerve - position supine, neurodynamic sequence: feet extension and pronation, knee extension, hip flexion (SLR – straight leg raise); one-direction proximal glide mobilisation (movement – knee extension –large amplitude of motion), one-direction distal glide mobilisation (movement – feet extension –large amplitude of motion), one-direction proximal tension mobilisation (movement – knee extension –small amplitude of motion et the end of the movement), one-direction distal tension mobilisation (movement – feet extension – small amplitude of motion et the end of the movement) b. peroneal nerve - position supine, neurodynamic sequence: feet flexion and supination, knee extension, hip flexion (SLR – straight leg raise), hip abduction; one-direction proximal glide mobilisation (movement – knee extension –large amplitude of motion), one-direction distal glide mobilisation (movement – feet extension –large amplitude of motion), one-direction proximal tension mobilisation (movement – knee extension –small amplitude of motion et the end of the movement), one-direction distal tension mobilisation (movement – feet extension – small amplitude of motion at the end of the movement) c. femoral nerve - position side lying, neurodynamic sequence: maximum hip and knee flection of untested lower limb, hip extension and knee flexion of tested lower limb; one-direction proximal glide mobilisation (movement – hip extension –large amplitude of motion), one-direction distal glide mobilisation (movement – knee flexion –large amplitude of motion), one-direction proximal tension mobilisation (movement – hip extension –small amplitude of motion et the end of the movement), one-direction distal tension mobilisation (movement – knee flexion – small amplitude of motion at the end of the movement). Standard protocol consisted of three series of 60 repetitions of glide and tension neurodynamic techniques separated by inter-series intervals of 15 s, twice a week for 10 sessions. The intervention will be delivered by experienced in neurodynamic techniques physiotherapist.. The intervention will be performed in two outpatient clinic in Silesia region of Poland. The duration of the each therapy session is 45 min. Therapy will be performed on peripheral nerves in lower and upper limb in patients with toxic or/and diabetic neuropathies, All participants receive all six nerve treatments.