Neural sensitivity in patients with adhesive capsulitis using modified upper limb neurodynamic testing

Background Chronic inflammation and fibrosis of the joint capsule in adhesive capsulitis (AC) may alter the neurodynamics of nervous tissues surrounding the capsule of the shoulder joint.Objectives The study was designed to observe the sensory response and neural tissue mobility during Modified Median Neurodynamic Test1 (MNT1), Radial Neurodynamic Test (RNT), and Modified Ulnar Neurodynamic Test (M-UNT) on symptomatic, compared to asymptomatic, upper limb patients with stage 2 AC.Methods This was an observational cross-sectional study. Assessment of neural tissue sensitivity was performed on 73 patients with stage 2 AC using M-MNT1, RNT, and M-UNT on both limbs. The type of sensory response produced during neurodynamic testing was recorded on the body chart and ROM of limited elbow extension (M-MNT1), shoulder abduction (RNT), and elbow flexion (M-UNT) was measured with a goniometer in degrees. The percentage of patients with positive tests (both abnormal sensory response and limited ROM) was calculated. After assessing the normality of variables, the intra-individual difference in ROM was analysed.Results Results of the study suggest that around 37% of patients had positive test responses for one of the modified neurodynamic tests. However, 67% of patients demonstrated significant differences in ROM between symptomatic and asymptomatic upper limbs.Conclusions About 37% of patients with stage 2 AC showed positive neural sensitivity response to upper limb neurodynamic testing. However, 67% of patients had restricted neural tissue mobility on symptomatic upper limbs.