Affiliations: Doctor of Physical Therapy Program, Sacred Heart University, Fairfield, CT, USA
Corresponding author: Sean P. Riley, PT, DPT, ScD, Doctor of Physical Therapy Program, Sacred Heart University, 5151 Park Avenue, Fairfield, CT 06825, USA. Tel.: +1 (203) 396 6840; Fax: (203) 365 4723; E-mail: [email protected].
Abstract: BACKGROUND:Median nerve neurodynamic testing is described in the literature with the scapula blocked and depressed and there are numerous descriptions of structural differentiation performed during testing. A better understanding of how these variables impact median nerve neurodynamic testing is warranted. PURPOSE:To compare the Upper Limb Tension Test A (ULTT A) with the scapula blocked and depressed to determine: the reliability of ULTT A with the scapula blocked and depressed; if there is a statistically significant difference between the left and right arms; and if there is a statistically significant difference for ULTT A with the scapula blocked or depressed. METHODS:This was a intertester and test-retest reliability and accuracy study. Elbow extension was measured with a standard goniometer. Sensory responses were captured with the Numeric Pain Rating Scale (NPRS). Subjects were randomly tested by Rater, side, and by test condition. RESULTS:The NPRS and end range elbow extension had moderate to good intertester reliability. There were poor to moderate findings for reliability of structural differentiation. There was no statistically significant difference (p > 0.05) between the left and right arms except for structural differentiation. There was a statistically significant difference between the scapula blocked vs scapula depressed test conditions except for the NPRS on the left arm (p = 0.08). CONCLUSIONS:ULTT A under the depressed scapula test condition is less reliable and more variable than the blocked scapula condition in the normal healthy population. Structural differentiation may not be a reliable or valid aspect of ULTT A.
Keywords: Median nerve, radiculopathy, reproducibility of results, diagnostic
tests, upper extremity