The Effect of Position and Movement of the Contralateral Limb on Median Nerve Tissue Tension in Normal Asymptomatic Individuals

In neural tension testing, it is critically important to establish a method to investigate the relative contribution of different neuromuscular mechanisms to resistance developed during and at the limit of the upper limb tension test. There is inadequate evidence on the effect of contralateral arm on neurophysiological responses during and at the limit of median nerve tissue tension.

To assess the effect of position and movement of the contralateral limb on median nerve tissue tension in normal asymptomatic young individuals.

This was prospective open study. 90 Normal asymptomatic individuals in age group of 18 to 25 years having unilateral Median nerve tissue tension were included in the study.

Plint, Goniometer & Assistant was taken to maintain the position of contralateral limb. The Median Neurodynamic test (MNT) was performed. Subject was instructed to report the first onset of pain (P1) and range of elbow extension was measured (R1). Then elbow was taken further to extension till subject's felt submaximal pain (P2) and range of elbow extension (R2) was taken at that point. Pain was measured on visual analogue scale (VAS). Contralateral Median Neurodynamic test (CMNT) was performed and the position was maintained by the assistant. Then on the tested side Median Neurodynamic test was performed again. The parameters taken were pain at onset (P1’) and ROM of elbow extension (R1’) at that point. Elbow was taken into further extension till subject's felt submaximal pain (P2’) and ROM of elbow extension (R2’) was taken at that point.

Effect of Contralateral Median neurodynamic position on intensity of pain elicited by Median Neurodynamic test at onset of pain and submaximal pain was statistically significant (p<0.001) and also on range of elbow extension was statistical significant (p< 0.001).

The contralateral limb position has an effect on ipsilateral median nerve tissue tension in terms of intensity of pain both at onset of pain & submaximal pain and elbow range of motion respectively.