Neural Mobility Examination Intervention Strategies

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10 21 2014,How Effective is Neural Mobilization,Ten RCT s reviewed. Different methods used for each,Different neurodynamic dysfunctions for each. No standardization for assessment or treatment,All utilized tensioning techniques. Conclusion,Limited evidence to support neural,mobilization. Justification,ifi i for f treatment based,b d on anatomy.
physiology clinical trials anecdotal evidence,Recommendations for Future Studies. Need to classify into homogeneous,subcategories,Need to standardize treatment and. assessment techniques,Then proceed with clinical research. 10 21 2014,Ideal Conditions for Nerve Health,Brief Review of Nerve Anatomy. Physiology,Connective Tissue,V Nervorum,Axonal Transport.
Nervi Nervorum,Connective Tissue Layers,Endoneurium. Perineurium,Epineurium,Mesoneurium,10 21 2014,Endoneurium. individual,Highly elastic,Perineurium,Contributes most. to nerve s tensile,Collagen based,Epineurium,connective. 10 21 2014,Epineurium,Mesoneurium,connective,Facilitates.
10 21 2014,Potential for Nerve Injury,Nerve passes through several tight anatomic. compartments along nerve bed,Conflict between free space and contents. Diminished compartment aperture,Increased volume of contents. Result restricted gliding between tissues in,the compartment interrupted nerve. physiology impaired blood supply,10 21 2014,Video Quiz.
This individual is stamping his foot and moving,in this manner because. A Of the toilet tissue stuck on his shoe,B The edge of the toilet seat cut off the blood. supply to the sciatic nerve and his leg has gone, C The toilet seat interrupted the axonal transport. system of the sciatic nerve and his leg has gone,D All of the above. Vasa Nervorum,Axonal Transport,Uninterrupted axonal transport is.
necessary for neuron health,Activity affects intra cellular motility. 10 21 2014,Axonal Transport,Antegrade flow,400 mm day. 1 6 mm day,Retrograde flow,200 mm day,Axonal Transport Vehicle. Goldstein AYN et al Axonal transport and the delivery of presynaptic components Curr Opin Neurobiol 2008 18 495 503. Kinesin Dynein Motor Protein, Encalada SE et al Stable kinesin and dynein assemblies drive the axonal transport of mammalian prion protein vesicles Cell 2011 144 551 65. 10 21 2014,Video Quiz,This individual is stamping their foot and moving.
in this manner because,A Of the toilet tissue stuck on their shoe. B The edgeg of the toilet seat cut off the blood, supply to the sciatic nerve and their leg has gone. C The toilet seat interrupted the axonal transport. system of the sciatic nerve and their leg has gone. D All of the above,Inflammation Axonal Transport,Inflammation. 10 21 2014,Nerve s Response to Injury,Mild focal compression. Injury to Schwann cell,Demyelination results,Nerve s Response to Injury.
Mild focal compression,Injury to Schwann cell,Demyelination results. More severe trauma,Degeneration of the distal axon. Reactive changes to the nerve cell body,Wallerian degeneration. Potential for axonal death,Seddon s Classification. Published in 1943,3 stages of injury,Useful in predicting outcome and.
formulating treatment,10 21 2014,Neuropraxia,Segmental reduction or block of. conduction,Axonal continuity preserved no wallerian. degeneration,Nerve conduction preserved distal and. proximal to the lesion,Full recovery,Axonotmesis,Axonal damage with preservation of. endoneurium,Distal wallerian degeneration occurs,Endoneurial tubes guide re growth of axon.
Neurotmesis,Most severe of nerve injuries,Connective tissue components of nerve. damaged or transected,Recovery cannot occur through axonal. regeneration alone,Surgical intervention required,10 21 2014. Sunderland s Classification,Published in 1951,5 grades of nerve injury. Neurpraxia Grade I,Axonotmesis Grade II,Neurotmesis Grades III IV V.
Grade III Injuries,Damage to the nerve Endoneurial tube. Endoneurium,Perineurium preserved,Results in intrafascicular scarring. Grade IV Injuries,Damage to the nerve fasciculi,Endoneurium. Perineurium,Epineurium preserved,Results in intraneural scarring. 10 21 2014,Grade V Injuries,Neurotmesis injury,Nerve trunk divided.
Surgical repair,Injury Without Axonal Degeneration. The nerve to the,Consists of C and,Protective and,pro inflammatory. EMG and NCV Testing,Of value in detecting large diameter motor. and A sensory nerve injury,Of no value in detecting small diameter nerve. Nervi Nervorum,Greening 2006 Wilbourn 2003,10 21 2014.
How do we identify these patients,Neural Sensitization. Very often occurs without axonal damage Dilley,et al 2005 Schmid et al 2013. Conduction velocities maintained, Involves sensitization of of A and C fibers of the. nervi nervorum nerve Bove et al 2003,Sensitized nerve fibers respond to pressure and. stretch Dilley et al 2005,Pressure responding fibers stretch responders by.
Stretch responders needed as little as 3 elongation. Mechanism of Occurrence,Inflammation in and around the nerve Dilley et. al 2005 Bove 2009,Interruption,p of axonal transport. p Dilleyy Bove,2008 Dilley et al 2013,Mechanical stress of stretch and or. compression Neuropraxia,10 21 2014,Vast number of nerve injuries not detected via. Neural sensitization involves injury to small,diameter A and C fibers of the nerve and.
nervi nervorum,Occurs through inflammation and interruption. of axonal transport system,Detected via palpation and stretch on clinical. Neural Mobility Examination amp Intervention Strategies An Overview Mark W Butler PT DPT OCS Cert MDT Objectives Review current state of evidence Review neuropathic pain and neural sensitivity Identify patients with neural sensitivity Quantify restricted neural mobility

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