Reliability of the radial and ulnar nerve biased upper extremity neural tissue provocation tests

Abstract

Study design: Within subjects test-retest design. Background: Neural tissue provocation tests (NTPTs) are used clinically to examine neural tissue mechanosensitivity in patients with musculoskeletal conditions. Previous studies suggest the median and radial nerve biased tests can be applied reliably using external fixation devices. Transfering these reliability data to a clinical setting where external fixation devices are not used may not be appropriate. Although median nerve biased NTPT can be applied reliably without external fixation devices, no data exist for the radial and ulnar nerve biased tests. Objectives: The purpose of this study was to examine intrarater reliability of the NTPTs biased toward the radial and ulnar nerves without external fixation devices. Methods and measures: The NTPTs biased towards the radial and ulnar nerves were examined on 45 asymptomatic participants. The examiner's perception of firm resistance defined the end position of each NTPT. Elbow range of motion was measured at this end position with an electrogoniometer. The order of NTPTs and side tested were randomized for each participant. Results: Repeated measures analysis of variance revealed no significant difference in elbow extension or flexion mobility between two trials for each NTPT (p > 0.05). Intraclass correlation coefficient (ICC_(2,1)) values ranged from 0.65 to 0.81 and minimal detectible difference (MDD) values ranged from 9.20 to 13.44 degrees. Conclusion: The examiner in this study was able to apply the NTPTs biased toward the radial and ulnar nerve in a reliable fashion on asymptomatic participants without external fixation devices. This study provides a basis for further research to investigate interexaminer reliability and between session reliability in a symptomatic population.

ACKNOWLEDGMENTS

The authors would like to thank Joseph Weir, PhD, for his assistance with data analysis and statistics. The authors also thank Katherine Newman, DPT, and Jennifer Schmelzle, DPT, for their assistance with data collection.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.