Mayank Shukla¹* and Sagarika Sharma²

¹Professor and Head, Department of Physiotherapy, SSAHS, Sharda University, Greater Noida, India
²Physiotherapist, Building Block Rehabilitation Centre, Rajouri Garden, Delhi, India

*Corresponding Author: Mayank Shukla, Professor and Head, Department of Physiotherapy, SSAHS, Sharda University, Greater Noida, India.

Received: August 22, 2023; Published: September 15, 2023

Abstract

Aim: The aim of the study was to rationalize and examine active, bilateral, and sequential neural mobilization as a tool for examination and treatment of the peripheral nervous system, especially the neurodynamically responsive structures. We looked at the effectiveness of battery of self -administered techniques using active, bilateral, and sequential pattern (ABS-NM) in conditions like cervical radiculopathy, brachial plexus related neural pain and musculoskeletal conditions indicative of compromise of brachial plexus.

Need of the study: Active movements are the main cause of the symptomatology however all the tests are passive in nature. Neurodynamic tests involve passive manoeuvres, but it has been found that whenever patient is moving actively, they tend to worsen their symptoms and there is reproduction of pain; mainly due to involvement of active structures like muscles, muscular-fascia and tendons which cover the brachial plexus and glide along its nerves. The use of extremities is always bilateral during daily activities in an active sequential manner and follows Bevor’s axiom.

Methods: The battery of the tests was developed from extensive review of literature and expert consensus on the brachial plexus anatomy, biomechanics, and clinical assessment using passive neural tension tests. Case studies were done to find out the effectiveness of this technique using measures of pain and disability like numeric pain rating scale (NPRS), and neck disability index (NDI).

Results: The ABS-NM has shown significant effect on the studied parameters – NPRS and NDI for two cases of cervical radiculopathy.

Conclusion: ABS-NM works as a therapeutic and diagnostic battery and proved active feedback to the individual from muscle contraction and movement.

Keywords: Brachial Plexus; Neural Mobilisation; Sliders; Tensioners; Structural Differentiation; Active Tension Tests

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Citation

Citation: Mayank Shukla and Sagarika Sharma. “Active, Bilateral, and Sequential - Neural Mobilization (ABS-NM): a Novel Therapeutic Approach and its Clinical Rationale". Acta Scientific Orthopaedics 6.10 (2023): 30-39.

Copyright

Copyright: © 2023 Mayank Shukla and Sagarika Sharma. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.