Neurodynamic Testing

When do we stop the test or consider it positive?

What to considering during the test?

Each joint positioning component is added until the pain is provoked or symptoms are reproduced.

Always keep the previous action held properly. Ask the patient if there are any symptoms after each movement and look to their face for signs of discomfort.

Median nerve

Position: Supine

Examiner: Facing cranially

• Shoulder girdle depression (proximal hand depresses shoulder and thigh is used to block the shoulder)

• Shoulder abducted to 90°

• Elbow flexed to 90° and wrist is neutral

• Extend the wrist and fingers

• Externally rotate the shoulder

• Extend the elbow

• Side bend neck away from the side being tested

When do we stop the test or consider it positive?

What to considering during the test?

Each joint positioning component is added until the pain is provoked or symptoms are reproduced.

Always keep the previous action held properly. Ask the patient if there are any symptoms after each movement and look to their face for signs of discomfort.

Median nerve

Position: Supine

Examiner: Facing cranially

• Shoulder girdle depression (proximal hand depresses shoulder and thigh is used to block the shoulder)

• Shoulder abducted to 90°

• Elbow flexed to 90° and wrist is neutral

• Extend the wrist and fingers

• Externally rotate the shoulder

• Extend the elbow

• Side bend neck away from the side being tested

Radial nerve

Position: Supine, lying diagonally with shoulder out of the bed, arm at the side, elbow flexed to 90°, neutral wrist and fingers

Examiner: Facing caudally

• Shoulder depression (depress with thigh)

• Elbow extension

• Medial rotation of the whole arm

• Wrist, finger and thumb flexion

• Side bend neck away from the side being tested

Ulnar nerve

Position: Supine

Examiner: Facing cranially

• Shoulder girdle depression (proximal hand depresses shoulder and thigh is used to block the shoulder)

• Shoulder abducted to 90°

• Elbow flexed to 90° and wrist is neutral

• Extend the wrist and fingers and pronate the forearm

• Externally rotate and abduct the shoulder (bringing patient’s fingers towards their ear)

• Side bend neck away from the side being tested

Slump test

Position: Seated

Examiner:

• Thoracic/lumbar flexion (place forearm on top of cervical and thoracic spine to prevent extension)

• Hands behind the back and cervical flexion

• One knee extension

• Dorsiflexion of extended foot

SLR

Position: Supine

Examiner:

• Hip flexed and knee extended

• Flex the hip and ask patient to inform when symptoms occur (usually between 30-70°)

• You can confirm the symptoms by moving out of the painful range and dorsiflexing (for tibial nerve).

Prone knee bend test - Femoral nerve

Position: Prone

Examiner:

• Full knee flexion

• Hip extension