Side-to-side elbow range of movement variability in an ulnar neurodynamic test sequence variant in asymptomatic people.

Abstract

Background: Range of motion (ROM) asymmetry between sides is one indicator of a positive neurodynamic test, but this has been less well studied for the ulnar nerve.

Objective: The purpose of this study was to investigate side-to-side variation in elbow ROM during an ulnar neurodynamic test sequence, including contralateral cervical side flexion, in 40 asymptomatic subjects.

Methods: A traditional goniometer was used to measure elbow flexion ROM at two end points, onset of resistance ( $R$ 1) and symptom onset ( $P$ 1). Two repeated measures of $R$ 1 and $P$ 1 were taken on each side.

Results: Reliability for $R$ 1 and $P$ 1 was found to be good (ICC $\ge 0.83$ , SEM $\le 5.37$ ) with no significant difference in mean ROM between sides. A significant relationship between sides was seen ( $r$ values $\ge 0.48$ ) and $R^2$ values $>0.23$ ; this indicates at least 23% of the variance observed in one limb was accounted for by range in the opposite limb. This relationship was slightly stronger for $R$ 1 than $P$ 1. Lower bound scores indicate that intra-individual ROM difference $>23^{°}$ for $R$ 1 and 22^° for $P$ 1 would exceed normal ROM asymmetry.

Conclusion: These findings provide clinicians with background information of ROM asymmetry during the ulnar neurodynamic test.