Pain location reliability of the median neurodynamic Test 1 in healthy subjects

Barbero, Marco and Castelli, Elena and Leoni, Diego Maria and Egloff, Michele (2011) Pain location reliability of the median neurodynamic Test 1 in healthy subjects. Italian journal of Physiotherapy, 1 (2). pp. 1-7. ISSN 2240-4929

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Aim. Neurodynamic tests have been introduced to assess the neural tissue mobility and sensitivity to mechanical stress. Therefore it is important for clinicians to understand neurodynamic tests’ normal and abnormal responses, in order to consider a diagnosis of neurogenic disorders. The purpose of this study was to investigate the reliability of the submaximal pain location induced by Median Neurodynamic Test 1 (MNT1) in healthy subjects. Methods. Three physical therapists (R, M, E) were involved in the study as examiners. Fifteen healthy volunteers were randomly allocated to one of five sessions. The examiners performed the MNT1 twice (t1, t2) on both sides on all the subjects. Examiners and side order were randomized and subjects waited fifteen minutes before receiving a second test on the same side. Subjects were instructed to stop the test at submaximal pain and to record the response on a body chart. In order to analyze the pain location the body charts were split in twenty-eight anatomical areas. Intraexaminer and interexaminer reliability of the painful response were investigated using the Jaccard index (JI). Additionally in each subject left and right painful responses similarity were analyzed. Results. The mean JI for intraexaminer reliability was 0.67 (SD 0.21) for R, 0.65 (SD 0.26) for M and 0.52 (SD 0.31) for E. The mean JI for inter-examiner reliability was 0.58 (SD 0.25) for M versus R, 0.51 (SD 0.28) for R versus E and 0.49 (SD 0.29) for M versus E. The mean JI for left and right comparison was 0.61 (SD 0.27). Conclusion. The reliability of submaximal pain location response during MNT1 in healthy subjects seems to be moderate.

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