Zusammenfassung
Eine modifizierte Version des neuralen Provokationstest via N. medianus wurde bei
12 Patienten mit einseitigen zervikobrachialen Schmerzen durchgeführt. Der Ellbogenextensionswinkel
wurde zum Zeitpunkt des Schmerzbeginns, des Überschreitens der Schmerztoleranzgrenze
und des Beginns der Muskelaktivität in den Mm. trapeziis und M. biceps brachii in
beiden Armen gemessen. Die Ergebnisse zeigten, dass die Ermittlung von Schmerzbeginn
und Schmerztoleranz reliabel war, die der Muskelaktivitäten nicht. Die Schmerzen traten
im symptomatischen Arm wesentlich früher ein als im gesunden Arm und das Bewegungsausmaß
war stärker eingeschränkt. Bei den meisten Patienten konnte man deren exakte Symptome
reproduzieren. Aus den Ergebnissen ergibt sich der Schluss, dass der modifizierte
Provokationstest via N. medianus zur Untersuchung der Mechanosensitivität der Neuralstrukturen
in der oberen Extremität dient.
Abstract
A modified version of the NPT was used in 12 patients with unilateral cervicobrachial
pain. The angles of elbow extension at onset of pain threshold and pain tolerance
and the onset of muscle activity in trapezius and biceps muscle were measured in both
arms. The results showed that the pain onsets were reliable, but not the muscle onsets.
The pain onsets occurred earlier in the symptomatic arm than in the asymptomatic arm
and the range of elbow extension was further restricted. In most patients their exact
symptoms were reproduced. It can be concluded that the modified version of the neural
provocation test via median nerve is a mean to assess the mechanosensitivity of neural
tissues in the upper limb.
Schlüsselwörter
Neurale Strukturen - Mechanosensitivität - neuraler Provokationstest - N. medianus
- zervikobrachiale Schmerzen
Key words
Neural tissues - mechanosensitivity - neural provocation test - median nerve - cervicobrachial
pain
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Brigitte van der Heide, PT, Grad Dip Manip Ther, MSc
Unit 3, 15 Parry St
Fremantle
Western Australia 6160
Email: freophysio@iinet.net.au