Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-1937
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.
Published in : BMC Musculoskeletal Disorders
Volume(Issue) : 10
Issue : 11
Publisher / Ed. Institution : BioMed Central
Issue Date: 2009
Language : Englisch / English
Subjects : Carpal tunnel syndrome; Ulnar nerve; Nerve function; Sensory testing; Manual muscle testing
Subject (DDC) : 616.7: Krankheiten des Bewegungsapparates, Orthopädie
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.
Departement: Gesundheit
Publication type: Beitrag in wissenschaftlicher Zeitschrift / Article in scientific Journal
Type of review: Peer review (Publikation)
DOI : 10.1186/1471-2474-10-11
10.21256/zhaw-1937
ISSN: 1471-2474
URI: https://digitalcollection.zhaw.ch/handle/11475/4925
License (according to publishing contract) : CC BY 2.0: Namensnennung 2.0 Generic
Appears in Collections:Publikationen Gesundheit



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.