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The impact of muscular variation on the neurodynamic test for the median nerve in a healthy population with Langer's axillary arch

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Abstract
Objective: The neurodynamic test of the median nerve (ULNT1) is frequently used to assess the mechanics and physiology of the brachial plexus and median nerve. The present Study looks for a positive ULNT1 in a healthy population with Langer's axillary arch (LAA) and analyzes whether LAA affects the elbow extension range of motion (EE-ROM) of the ULNT1. Method: Of 640 volunteers screened, 26 LAA sides were finally included. Additional history taking revealed "minor symptoms" in some subjects. Minor symptoms do not qualify as a disorder because there is no interference with daily activities and no medical advice is sought. This study investigates whether the ULNT1 can (re)produce minor symptoms or abnormal responses in subjects with LAA. The EE-ROM vas compared between the subjects' left and right side, anti the subtraction angle-which is the effect of placing the cervical spine in contralateral lateral flexion-was compared between LAA sides and controls. Results: Langer's axilliary arch sides showed a significant increase in the occurrence of minor symptoms and positive ULNT1, but no influence was observed on the EE-ROM. Conclusions: These findings suggest that LAA may be capable of transiently provoking the axillary neurovascular bundle. The unaffected EE-ROM may be the consequence of a vascular origin of the minor symptoms or the consequence of an ulnar nerve/medial cord response to the ULNT1.
Keywords
regional anatomy, brachial plexus, median nerve, neurovascular syndrome, diagnosis, rehabilitation, CARPAL-TUNNEL-SYNDROME, THORACIC OUTLET SYNDROME, AXILLOPECTORAL MUSCLE, UPPER-LIMB, NEUROPATHIC PAIN, DIAGNOSIS, COMPRESSION, NOCICEPTORS, ENTRAPMENT, MANAGEMENT

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MLA
Van Hoof, Tom, Carl Vangestel, Malcolm Forward, et al. “The Impact of Muscular Variation on the Neurodynamic Test for the Median Nerve in a Healthy Population with Langer’s Axillary Arch.” JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS 31.6 (2008): 474–483. Print.
APA
Van Hoof, T., Vangestel, C., Forward, M., Verhaeghe, B., Van Thilborgh, L., Plasschaert, F., De Muynck, M., et al. (2008). The impact of muscular variation on the neurodynamic test for the median nerve in a healthy population with Langer’s axillary arch. JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS, 31(6), 474–483.
Chicago author-date
Van Hoof, Tom, Carl Vangestel, Malcolm Forward, Bram Verhaeghe, Lien Van Thilborgh, Frank Plasschaert, Martine De Muynck, Guy Vanderstraeten, and Katharina D’Herde. 2008. “The Impact of Muscular Variation on the Neurodynamic Test for the Median Nerve in a Healthy Population with Langer’s Axillary Arch.” Journal of Manipulative and Physiological Therapeutics 31 (6): 474–483.
Chicago author-date (all authors)
Van Hoof, Tom, Carl Vangestel, Malcolm Forward, Bram Verhaeghe, Lien Van Thilborgh, Frank Plasschaert, Martine De Muynck, Guy Vanderstraeten, and Katharina D’Herde. 2008. “The Impact of Muscular Variation on the Neurodynamic Test for the Median Nerve in a Healthy Population with Langer’s Axillary Arch.” Journal of Manipulative and Physiological Therapeutics 31 (6): 474–483.
Vancouver
1.
Van Hoof T, Vangestel C, Forward M, Verhaeghe B, Van Thilborgh L, Plasschaert F, et al. The impact of muscular variation on the neurodynamic test for the median nerve in a healthy population with Langer’s axillary arch. JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS. 2008;31(6):474–83.
IEEE
[1]
T. Van Hoof et al., “The impact of muscular variation on the neurodynamic test for the median nerve in a healthy population with Langer’s axillary arch,” JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS, vol. 31, no. 6, pp. 474–483, 2008.
@article{430394,
  abstract     = {Objective: The neurodynamic test of the median nerve (ULNT1) is frequently used to assess the mechanics and physiology of the brachial plexus and median nerve. The present Study looks for a positive ULNT1 in a healthy population with Langer's axillary arch (LAA) and analyzes whether LAA affects the elbow extension range of motion (EE-ROM) of the ULNT1.
Method: Of 640 volunteers screened, 26 LAA sides were finally included. Additional history taking revealed "minor symptoms" in some subjects. Minor symptoms do not qualify as a disorder because there is no interference with daily activities and no medical advice is sought. This study investigates whether the ULNT1 can (re)produce minor symptoms or abnormal responses in subjects with LAA. The EE-ROM vas compared between the subjects' left and right side, anti the subtraction angle-which is the effect of placing the cervical spine in contralateral lateral flexion-was compared between LAA sides and controls.
Results: Langer's axilliary arch sides showed a significant increase in the occurrence of minor symptoms and positive ULNT1, but no influence was observed on the EE-ROM.
Conclusions: These findings suggest that LAA may be capable of transiently provoking the axillary neurovascular bundle. The unaffected EE-ROM may be the consequence of a vascular origin of the minor symptoms or the consequence of an ulnar nerve/medial cord response to the ULNT1.},
  author       = {Van Hoof, Tom and Vangestel, Carl and Forward, Malcolm and Verhaeghe, Bram and Van Thilborgh, Lien and Plasschaert, Frank and De Muynck, Martine and Vanderstraeten, Guy and D'Herde, Katharina},
  issn         = {0161-4754},
  journal      = {JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS},
  keywords     = {regional anatomy,brachial plexus,median nerve,neurovascular syndrome,diagnosis,rehabilitation,CARPAL-TUNNEL-SYNDROME,THORACIC OUTLET SYNDROME,AXILLOPECTORAL MUSCLE,UPPER-LIMB,NEUROPATHIC PAIN,DIAGNOSIS,COMPRESSION,NOCICEPTORS,ENTRAPMENT,MANAGEMENT},
  language     = {eng},
  number       = {6},
  pages        = {474--483},
  title        = {The impact of muscular variation on the neurodynamic test for the median nerve in a healthy population with Langer's axillary arch},
  url          = {http://dx.doi.org/10.1016/j.jmpt.2008.06.007},
  volume       = {31},
  year         = {2008},
}

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