Reliability of clinical tests to evaluate nerve function and mechanosensitivity of the upper limb peripheral nervous system

Schmid, Annina Barbara; Brunner, Florian; Luomajoki, Hannu; Held, Ulrike; Bachmann, Lucas M.; Künzer, Sabine; Coppierters, Michel W.

doi:10.21256/zhaw-1937

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-1937

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Reliability of clinical tests to evaluate nerve function and mechanosensitivity of the upper limb peripheral nervous system
Authors:	Schmid, Annina Barbara Brunner, Florian Luomajoki, Hannu Held, Ulrike Bachmann, Lucas M. Künzer, Sabine Coppierters, Michel W.
DOI:	10.21256/zhaw-1937 10.1186/1471-2474-10-11
Published in:	BMC Musculoskeletal Disorders
Volume(Issue):	10
Issue:	11
Issue Date:	2009
Publisher / Ed. Institution:	BioMed Central
ISSN:	1471-2474
Language:	English
Subjects:	Carpal tunnel syndrome; Ulnar nerve; Nerve function; Sensory testing; Manual muscle testing
Subject (DDC):	616.7: Diseases of musculoskeletal system and orthopaedics
Abstract:	Background: Clinical tests to assess peripheral nerve disorders can be classified into two categories: tests for afferent/efferent nerve function such as nerve conduction (bedside neurological examination) and tests for increased mechanosensitivity (e.g. upper limb neurodynamic tests (ULNTs) and nerve palpation). Reliability reports of nerve palpation and the interpretation of neurodynamic tests are scarce. This study therefore investigated the intertester reliability of nerve palpation and ULNTs. ULNTs were interpreted based on symptom reproduction and structural differentiation. To put the reliability of these tests in perspective, a comparison with the reliability of clinical tests for nerve function was made. Methods: Two experienced clinicians examined 31 patients with unilateral arm and/or neck pain. The examination included clinical tests for nerve function (sensory testing, reflexes and manual muscle testing (MMT)) and mechanosensitivity (ULNTs and palpation of the median, radial and ulnar nerve). Kappa statistics were calculated to evaluate intertester reliability. A meta-analysis determined an overall kappa for the domains with multiple kappa values (MMT, ULNT, palpation). We then compared the difference in reliability between the tests of mechanosensitivity and nerve function using a one-sample t-test. Results: We observed moderate to substantial reliability for the tests for afferent/efferent nerve function (sensory testing: kappa = 0.53; MMT: kappa = 0.68; no kappa was calculated for reflexes due to a lack of variation). Tests to investigate mechanosensitivity demonstrated moderate reliability (ULNT: kappa = 0.45; palpation: kappa = 0.59). When compared statistically, there was no difference in reliability for tests for nerve function and mechanosensitivity (p = 0.06). Conclusion: This study demonstrates that clinical tests which evaluate increased nerve mechanosensitivity and afferent/efferent nerve function have comparable moderate to substantial reliability. To further investigate the clinometric properties of these tests, more studies are needed to evaluate their validity.
URI:	https://digitalcollection.zhaw.ch/handle/11475/4925
Fulltext version:	Published version
License (according to publishing contract):	CC BY 2.0: Attribution 2.0 Generic
Departement:	School of Health Sciences
Appears in collections:	Publikationen Gesundheit

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Schmid, A. B., Brunner, F., Luomajoki, H., Held, U., Bachmann, L. M., Künzer, S., & Coppierters, M. W. (2009). Reliability of clinical tests to evaluate nerve function and mechanosensitivity of the upper limb peripheral nervous system. BMC Musculoskeletal Disorders, 10(11). https://doi.org/10.21256/zhaw-1937

Schmid, A.B. et al. (2009) ‘Reliability of clinical tests to evaluate nerve function and mechanosensitivity of the upper limb peripheral nervous system’, BMC Musculoskeletal Disorders, 10(11). Available at: https://doi.org/10.21256/zhaw-1937.

A. B. Schmid et al., “Reliability of clinical tests to evaluate nerve function and mechanosensitivity of the upper limb peripheral nervous system,” BMC Musculoskeletal Disorders, vol. 10, no. 11, 2009, doi: 10.21256/zhaw-1937.

SCHMID, Annina Barbara, Florian BRUNNER, Hannu LUOMAJOKI, Ulrike HELD, Lucas M. BACHMANN, Sabine KÜNZER und Michel W. COPPIERTERS, 2009. Reliability of clinical tests to evaluate nerve function and mechanosensitivity of the upper limb peripheral nervous system. BMC Musculoskeletal Disorders. 2009. Bd. 10, Nr. 11. DOI 10.21256/zhaw-1937

Schmid, Annina Barbara, Florian Brunner, Hannu Luomajoki, Ulrike Held, Lucas M. Bachmann, Sabine Künzer, and Michel W. Coppierters. 2009. “Reliability of Clinical Tests to Evaluate Nerve Function and Mechanosensitivity of the Upper Limb Peripheral Nervous System.” BMC Musculoskeletal Disorders 10 (11). https://doi.org/10.21256/zhaw-1937.

Schmid, Annina Barbara, et al. “Reliability of Clinical Tests to Evaluate Nerve Function and Mechanosensitivity of the Upper Limb Peripheral Nervous System.” BMC Musculoskeletal Disorders, vol. 10, no. 11, 2009, https://doi.org/10.21256/zhaw-1937.