Reliability and validity of modified upper limb neurodynamic tests in patients with cervical radiculopathy.
Rupa Zanwar, Surendra Wani
PMID 38510155WHAT IT FOUND
Modified median and ulnar neurodynamic tests produced consistent elbow angles at the point pain started in 33 patients with cervical radiculopathy when repeated by one physiotherapist and by three physiotherapists over three days.
Key findings
01The modified median test showed substantial intra-rater reliability for the elbow extension angle at pain onset (ICC 0.80) and substantial inter-rater reliability (ICC 0.77).
02The modified ulnar test showed substantial intra-rater reliability for the elbow flexion angle at pain onset (ICC 0.77) and substantial inter-rater reliability (ICC 0.79).
03The modified median test score correlated strongly with the standard median test score (r = 0.767).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Four of the 37 recruited patients did not complete the third testing day, so the analysed sample was 33 patients. Only patients who already had a positive response to standard median or ulnar neurodynamic testing were included, so the results apply to a pre-selected symptomatic group. The study used three experienced physiotherapists who had at least 5 years of experience and training in neurodynamic tests, so reliability in less experienced clinicians is not shown. The difference in elbow angle between the symptomatic and asymptomatic sides was not used to interpret a positive response. The modified ulnar test was not correlated with the standard ulnar test because the outcome measures were different. The study was conducted at one hospital department, so generalisability to other settings is limited.
Declared interests
The authors declared no conflicts of interest. No financial or material support was received.
The easy way to misread this
Do not conclude that the modified neurodynamic tests diagnose cervical radiculopathy. This study measured consistency of the pain-onset elbow angle across repeated testing and across three physiotherapists, and it correlated the modified median test with the standard median test. The paper reports reliability and correlation with standard neurodynamic tests, not diagnostic accuracy.