NEURAL MOBILITY

Question 1

What is the result of the movement of the nervous system

Answer 1

Nutrition of the nerves and the nerves target tissues

Question 2

What occurs to the nerve root with hip flexion in SLR

Answer 2

It moves out of the ipsilateral IVF and contralateral nerve root gets pulled relatively in through the IVF
- There is also some lateral shifting of spinal canal contents

Question 3

Normal fixation points of the slumps test

Answer 3

• Popliteal region, C6, T6, L4

- Normal to feel symptoms and/or tightness here

Question 4

What are abnormal fixation points

Answer 4

• Scarring from muscle injury - Past disc injury where there is fibrous tissue where disc has remodelled
• Ligament hypertrophy - leading to narrowing of passageway

Question 5

When do fixation points matter

Answer 5

• Different left and right

- Relates to their presentation (complaint)

Question 6

What are some subjective findings that would lead you to think it may be neurodynamic related.

Answer 6

• Weird description of pain
• Previous or persistent injury
• Increase repetition or speed of work or sport
• Lines of symptom distribution (may not relate to nerve root or peripheral nerve distribution)
• Aggravated in positions of neural tension
  _ multiple problems in the same limb

Question 7

What are some compensations you will see during SLR? What does the use of a compensatory pattern indicate?

Answer 7

• Chin lift
• Hip hiking
• That you have gone past R1

Question 8

Neck flexion =

Answer 8

Chin to chest

Question 9

Cranial vertebral flexion =

Answer 9

Chin to throat

Question 10

Does neck flexion or cranial vertebral flexion add more tension to the system

Answer 10

cranial vertebral flexion

Question 11

in the slump test CV neck extension will cause…

Answer 11

relief of symptoms

Question 12

When should you ask about symptoms in the slumps test

Answer 12

at each new addition

Question 13

In a slump test, adverse neural mobility is likely a part of the problem if what occurs…

Answer 13

• Pts symptoms or something similar are reproduced with testing (+/- abnormal endfeel)
• Range achieved with testing is less than contralateral side or expected normal
• ROM or symptoms of test change with movement of remote areas

Question 14

What can cause referred pain to a dermatome, myotome, of sclerotome

Answer 14

a segmental ligament, muscle, or joint (around the facets)

Question 15

What type of neurodynamic treatment should you begin with

Answer 15

first a slider then tensioners

Question 16

What is the rule of thumb for which joints to move for sliding

Answer 16

start with those located remote of the symptom and then progress to closer

Question 17

Goal of slider. How to perform?

Answer 17

to promote movement.

As you add tension to one part of the system decrease it in another

Question 18

Goal of tensioner. How do you perform?

Answer 18

To improve nutrition Add tension to both ends of the system (head down, leg up)

Question 19

Contraindication for neurodynamic mobility treatment

Answer 19

• In the present of hard neuron signs
• Worsening symptoms
• Undiagnosed symptoms
• Severe irritability

Question 20

What is indirect treatment

Answer 20

Add on to gliders and tensioners

• Interface
• Posture

Question 21

how many reps of Sliders do you give?

Answer 21

10-50reps 1-3 sets (max out at 50)

Question 22

how do you progress treatment

Answer 22

• Go further into range or resistance (don’t provoke pain just mild-moderate stretch)
• Increase reps
• Add movement through components closer to symptomatic area
• Incorporate additional sources of tension
• Treat the interface with or without neural tension

Question 23

What do you want to determine before moving into greater sensation producing movements

Answer 23

The latent response