Control Condition, Stretching
Conditions
Keywords
stretching, stiffness, nerve, muscle, flexibility, hip
Brief summary
Neurodynamic mobilization techniques are widely applied in rehabilitation and physiotherapy to enhance the mobility and function of peripheral nerves. Two main approaches are distinguished : Nerve tensioning and nerve flossing. They both involve proximal and distal joint movements to induce greater neural sliding while avoiding excessive tensile stress. However, contradictory findings following neurodynamic stretching highlighted the current lack of consensus regarding the position that should be used. Moreover, neurodynamic techniques are of interest for patients, it appeared it could also be applied in healthy individuals and more particularly in athletes. Accordingly, the primary objective of the present study was to determine the immediate effect of two hip positions (adduction vs. abduction) during neurodynamic flossing techniques on the sciatic nerve and hamstring tissues using the shear wave elastography (SWE, a form of ultrasonography).
Detailed description
Neurodynamic mobilization techniques are frequently applied in rehabilitation settings to enhance the mobility and function of peripheral nerves, particularly in the management of neuropathic pain such as carpal tunnel syndrome, radiculopathies, or sciatica. Two main approaches are distinguished. Nerve tensioning involves maintaining the nerve stretched at the end of the joint range of motion with relatively limited excursion. It is similar to a static stretching intervention but with distal (ankle) and proximal (cervical) tensions. Nerve flossing (also termed gliding or sliders), consists of alternating proximal and distal joint movements to induce greater neural sliding while avoiding excessive tensile stress. Both techniques appear efficient. However, contradictory findings following neurodynamic stretching highlighted the current lack of consensus regarding the angular position that could be used. For instance, hip rotations or hip adduction could impact muscle or nerve tissue changes, particularly in healthy tissues. Moreover, neurodynamic techniques are of interest for patients, it appeared it could also be applied in healthy individuals and more particularly in athletes. Performed in patients, healthy or athletes, no study has compared different hip positions. Accordingly, the primary objective of the present study was to determine the immediate effect of two hip positions (adduction vs. abduction) during neurodynamic flossing techniques on the sciatic nerve and hamstring tissues using the shear wave elastography (SWE, a form of ultrasonography). This method has been shown reliable to provide non-invasive real-time assessments of soft tissues elastic properties.
Interventions
Neurodynamic flossing was applied at pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. During the neurodynamic conditions, head and ankle movement permitted to mobilize nerve tissues. Flossing is the alternation of these movements every 2 seconds.
Sponsors
University of Burgundy
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* healthy * physical active * no injuries (lower limb or back pain) in the past 3 months
Exclusion criteria
* Specific lower limb (hamstring) injuries in the past 2 years * Not restraining activity 24h before participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Nerve shear wave velocity using elastography in neutral position | Before the intervention and at the end (immediately after) the intervention | Shear wave velocity of the sciatic nerve will be evaluated by using an ultrasound (echography) device with a specific mode called "shear wave elastography". Briefly, the ultrasound probe will deliver an ultrasound wave. The propagation speed (called '"shear wave velocity") will be measured by the same probe. The greater the velocity is, the harder the tissue is. The hip position was neutral (alignment between the lower limb and the trunk). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Nerve shear wave velocity using elastography in experimental position | Before the intervention and at the end (immediately after) the intervention | Shear wave velocity of the sciatic nerve will be evaluated by using an ultrasound (echography) device with a specific mode called "shear wave elastography". Briefly, the ultrasound probe will deliver an ultrasound wave. The propagation speed (called '"shear wave velocity") will be measured by the same probe. The greater the velocity is, the harder the tissue is. The hip position was the experimental position (i.e., adduction or abduction depending on the randomisation). |
| Muscle shear wave velocity using elastography in neutral position | Before the intervention and at the end (immediately after) the intervention | Shear wave velocity of the biceps femoris muscle will be evaluated by using an ultrasound (echography) device with a specific mode called "shear wave elastography". Briefly, the ultrasound probe will deliver an ultrasound wave. The propagation speed (called '"shear wave velocity") will be measured by the same probe. The greater the velocity is, the harder the tissue is. The hip position was neutral (alignment between the lower limb and the trunk). |
| Muscle shear wave velocity using elastography in the experimental position | Before the intervention and at the end (immediately after) the intervention | Shear wave velocity of the biceps femoris muscle will be evaluated by using an ultrasound (echography) device with a specific mode called "shear wave elastography". Briefly, the ultrasound probe will deliver an ultrasound wave. The propagation speed (called '"shear wave velocity") will be measured by the same probe. The greater the velocity is, the harder the tissue is. The hip position was the experimental position (i.e., adduction or abduction depending on the randomisation). |
| Hamstring force | Before the intervention and at the end (immediately after) the intervention | Maximal torque during a maximal voluntary hamstring contraction |
| Biceps femoris electromyographic activity | Before the intervention and at the end (immediately after) the intervention | Electromyographic activity of biceps femoris muscle |
| Semitendinosus electromyographic activity | Before the intervention and at the end (immediately after) the intervention | Electromyographic activity of semitendinosus |
| passive knee extension | Before the intervention and at the end (immediately after) the intervention | The final passive range of motion of the hamstring muscles |
| Global flexibility | Before the intervention and at the end (immediately after) the intervention | the stand and reach test to evaluate flexibility (in centimeters) |
| Slump test | Before the intervention and at the end (immediately after) the intervention | Seated flexibility using the slump test (in degrees) |
| discomfort | At the end (immediately after) the intervention | rating of perceived discomfort during the intervention (from 1 to 10, no discomfort to maximal discomfort, respectively) |
Countries
France
Contacts
CONTACTNicolas Babault
CONTACTCarole Cometti
PRINCIPAL_INVESTIGATORNicolas Babault
universite bourgogne europe
Outcome results
None listed