Untersuchung der klinischen Effektivität eines modifizierten neuralen Provokationstests bei Patienten mit zervikobrachialen Schmerzen

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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