Effectiveness of Neurodynamic Mobilization versus Conventional Therapy on Spasticity Reduction and Upper Limb Function in Tetraplegic Patients

STUDY DESIGN: The study employed a pre- and post-test experimental design. PURPOSE: This study was designed to assess the effect of neurodynamic mobilization of the median nerve on upper limb spasticity in tetraplegic patients. OVERVIEW OF LITERATURE: Spasticity is a common and potentially disabling and bothersome complication in patients with spinal cord lesion; this disorder can negatively influence the quality of life by restricting the patient’s ability to perform activities of daily living. Neural mobilization is currently used for reducing the spasticity in individuals with neurological disorders. METHODS: Twenty subjects with traumatic spinal cord injury (level C5–C8) and upper limb spasticity in the finger and wrist flexors were enrolled. They were randomly allocated to two different groups using a computer-generated randomization schedule: group I comprised the neurodynamic mobilization group (n=11) and group II was the conventional therapy group (n=9); the subjects were administered therapy for 5 days every week for a period of 4 weeks. Upper limb spasticity was assessed using the Modified Ashworth Scale for wrist and finger flexors; F-wave amplitude, latency, and F-wave/M-wave amplitude ratio (F/M ratio) were examined using the F-wave scores of the median nerve; and upper limb function was determined using the Capabilities of Upper Extremity (CUE) Questionnaire. RESULTS: After 4 weeks of intervention, between-group comparisons showed a significant difference in the pre-intervention and postintervention scores on the Modified Ashworth Scale score for wrist flexors (−1.64±0.67), Modified Ashworth Scale score for finger flexors (−1.00±0.63), F-wave amplitude (−154.09±220.86), F/M ratio (−0.18±0.24), and CUE scores (17.82±13.49). CONCLUSIONS: These results suggest that neurodynamic mobilization of the median nerve may be effective for upper limb spasticity control and upper limb functional improvement in tetraplegic patients.