This study investigated the utility of using a neurodynamic test, the Slump test by itself and with qualifiers to identify neuropathic pain (NeP). The study utilized a control group and a low back pain group. The low back pain group was pre-diagnosed as NeP or non neuropathic pain (NNP) by an experienced clinician using an accepted diagnostic examination. A slump test was performed recording knee ROM, pain location and verbal pain descriptors followed by Quantitative Sensory Testing (QST). Various versions of the slump test were compared to the pre test diagnosis. Sensitivity, specificity and likelihood ratios were calculated. The conventional slump test was shown to be a sensitive and moderately specific screening test for NeP. Including whether pain extended below the knee dramatically increased specificity. QST revealed localized cold sensation hyposensitivity, widespread cold pain hyposensitivity and suggestions of increased thresholds of pressure pain levels.

This study investigated the utility of using a neurodynamic test, the Slump test by itself and with qualifiers to identify neuropathic pain (NeP). The study utilized a control group and a low back pain group. The low back pain group was pre-diagnosed as NeP or non neuropathic pain (NNP) by an experienced clinician using an accepted diagnostic examination. A slump test was performed recording knee ROM, pain location and verbal pain descriptors followed by Quantitative Sensory Testing (QST). Various versions of the slump test were compared to the pre test diagnosis. Sensitivity, specificity and likelihood ratios were calculated. The conventional slump test was shown to be a sensitive and moderately specific screening test for NeP. Including whether pain extended below the knee dramatically increased specificity. QST revealed localized cold sensation hyposensitivity, widespread cold pain hyposensitivity and suggestions of increased thresholds of pressure pain levels.

Study Design: A blinded, prospective diagnostic test study was conducted.<p>Objectives: To assess the inter-tester reliability of clinical examination items for carpal tunnel syndrome (CTS), to assess the validity of individual clinical test items and self-report measures for the diagnosis of CTS and to assess the accuracy of an optimum test item cluster for the diagnosis of CTS.<p>Study Rational: Examination of the diagnostic validity of various clinical tests for the diagnosis of CTS has shown mixed results and the reliability of many of these tests has not been determined. The majority of the diagnostic validity research for CTS has examined tests individually which is in contrast to clinical practice where the results of multiple tests are combined as part of the clinical reasoning process in order to formulate a differential diagnosis: the test item cluster, derived through logistic regression, is proposed as a means to integrate the validity of multiple tests. Methods: 37 subjects (74 hands) were recruited from a convenience sample of consecutive patients referred to for electrodiagnostic (EDX) testing due to upper extremity symptomatic complaints. Subjects underwent EDX testing followed by completion of self-report questionnaires and a standardized clinical examination by examiners blinded to EDX results. Diagnostic validity was determined for both general and restricted CTS classification groupings. <p>Results: Out of 18 clinical test items, 12 had reliability coefficients (i.e. ICC or Kappa) of .40 or greater. There were 10 clinical exam and self-report items that were found to have likelihood point estimates above 2 or below 0.50 for the general diagnostic classification and 6 items had acceptable validity for the restricted classification. The test item cluster (TIC) derived for the general classification included hand numbness and symptom reproduction with the upper limb neurodynamic test 1. The TIC derived for the restricted classification included hand numbness and the overall score of the symptom component of the Bringham Carpal Tunnel Questionnaire. The 95% confidence intervals for most likelihood ratio point estimates were wide. <p>Conclusions: The TICs for both classification groupings did not yield improved diagnostic validity beyond that found with the single best test item (hand numbness). The value of the single best test item hand numbness was in a negative response. Further investigation is required to validate the TIC and the single best test item and to improve the point estimate precision.

Study Design: A blinded, prospective diagnostic test study was conducted.<p>Objectives: To assess the inter-tester reliability of clinical examination items for carpal tunnel syndrome (CTS), to assess the validity of individual clinical test items and self-report measures for the diagnosis of CTS and to assess the accuracy of an optimum test item cluster for the diagnosis of CTS.<p>Study Rational: Examination of the diagnostic validity of various clinical tests for the diagnosis of CTS has shown mixed results and the reliability of many of these tests has not been determined. The majority of the diagnostic validity research for CTS has examined tests individually which is in contrast to clinical practice where the results of multiple tests are combined as part of the clinical reasoning process in order to formulate a differential diagnosis: the test item cluster, derived through logistic regression, is proposed as a means to integrate the validity of multiple tests. Methods: 37 subjects (74 hands) were recruited from a convenience sample of consecutive patients referred to for electrodiagnostic (EDX) testing due to upper extremity symptomatic complaints. Subjects underwent EDX testing followed by completion of self-report questionnaires and a standardized clinical examination by examiners blinded to EDX results. Diagnostic validity was determined for both general and restricted CTS classification groupings. <p>Results: Out of 18 clinical test items, 12 had reliability coefficients (i.e. ICC or Kappa) of .40 or greater. There were 10 clinical exam and self-report items that were found to have likelihood point estimates above 2 or below 0.50 for the general diagnostic classification and 6 items had acceptable validity for the restricted classification. The test item cluster (TIC) derived for the general classification included hand numbness and symptom reproduction with the upper limb neurodynamic test 1. The TIC derived for the restricted classification included hand numbness and the overall score of the symptom component of the Bringham Carpal Tunnel Questionnaire. The 95% confidence intervals for most likelihood ratio point estimates were wide. <p>Conclusions: The TICs for both classification groupings did not yield improved diagnostic validity beyond that found with the single best test item (hand numbness). The value of the single best test item hand numbness was in a negative response. Further investigation is required to validate the TIC and the single best test item and to improve the point estimate precision.

Introduction Lateral elbow pain is a common disorder and affects 1-3 % of the population each year. Beside the typical characterization with pain in restricted dorsal and radial deviation of the wrist and local tenderness of the lateral epicondyle, a neurodynamic dysfunction of the radial nerve can co-exist with the tendon dysfunction.  Purpose The aim of the study was to evaluate the effects of individualized neurodynamic treatment in combination with neurodynamic self-treatment in patient with persistent lateral elbow pain with a neurodynamic dysfunction of the radial nerve on grip strength, pain, disability, and function.  Method A single subject experimental design with A-B-A design was conducted. Seven participants with lateral elbow pain and a neurodynamic dysfunction of the radial nerve were recruited for the study. Five participants completed the study which consisted of individualized neurodynamic treatment directed to the neurodynamic dysfunction in combination with home exercises which included self-mobilization with sliders and/or tensioners in combination of the strengthening- and stretching exercises. The treatment was evaluated by pain-free and maximal grip strength, the Disabilities of the Arm, Shoulder and Hand (DASH) and Patient-rated Tennis Elbow Evaluation (PRTEE) questionnaires and range of motion of the upper limb neurodynamic test (ULNT) biased n. radialis.   Results The result of this SSED shows that neurodynamic treatment with manual mobilization and self-mobilization improves the ROM of the ULNT n. radialis in all five participants. Neurodynamic treatment also improved outcomes of DASH and PRTEE in 3 of the 5 participants.  Conclusion Neurodynamic treatment including manual mobilization and self-mobilization in combination with individual strength exercises tends to improve self-rated pain and disability, function and mechanosenstivity of the radial nerve in patients with persistent lateral elbow pain.

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