Peripheral nerves are subjected to mechanical tension during limb movements and body postures. Nerve response to tensile stress can be assessed in vivo with shear-wave elastography (SWE). Greater tensile loads can lead to greater stiffness, which can be quantified using SWE. Therefore, this study aimed to conduct a systematic review and meta-analysis to perform an overview of the effect of joint movements on nerve mechanical properties in healthy nerves. The initial search (July 2023) yielded 501 records from six databases (PubMed, Embase, Scopus, Web of Science, Cochrane, and Science Direct). A total of 16 studies were included and assessed with a modified version of the Downs and Black checklist. Our results suggest an overall tendency for stiffness increase according to a pattern of neural tensioning. The main findings from the meta-analysis showed a significant increase in nerve stiffness for the median nerve with wrist extension (SMD [95%CI]: 3.16 [1.20, 5.12]), the ulnar nerve with elbow flexion (SMD [95%CI]: 2.91 [1.88, 3.95]), the sciatic nerve with ankle dorsiflexion (SMD [95%CI]: 1.13 [0.79, 1.47]), and the tibial nerve with both hip flexion (SMD [95%CI]: 2.14 [1.76, 2.51]) and ankle dorsiflexion (SMD [95%CI]: 1.52 [1.02, 2.02]). The effect of joint movement on nerve stiffness also depends on the nerve segment, the amount of movement of the joint mobilized, and the position of other joints comprised in the entirety of the nerve length. However, due to the limited number of studies, many aspects of nerve behavior together with the effect of using different ultrasound equipment or transducers for nerve stiffness evaluation still need to be fully investigated.
Background/Objectives: Electrical threshold testing (ETT) offers a promising method for assessing somatosensory function. Despite its growing use, fundamental aspects such as the physiological recovery time required between repeated threshold measurements remain poorly understood. This gap is critical when evaluating sensory, motor, or pain thresholds (EST, EMT, EPT) in pre–post designs or rapid intra-session protocols. The aim is to investigate the short-term recovery dynamics of electrical thresholds following electrical threshold testing, and to determine the minimum interval required for values to return to a stable baseline. Methods: In this pilot, repeated-measures study, 10 healthy adults (20 upper limbs) underwent three progressive stimulation trials (sensory, motor, and pain). Electrical thresholds were assessed at fixed recovery intervals (0–120 s), with duplicate measurements at each time point. Stability was defined as the absence of significant differences between repeated measures. Results: EST stabilized rapidly after sensory or motor stimulation, showing no significant differences beyond 0 and 15 s, respectively. Within pain stimulation, EST recovered at 60 s. EMT showed immediate recovery with motor stimulation and required longer recovery with pain stimulation, with stabilization observed at 90 s. EPT exhibited the highest variability, with the smallest time-dependent differences observed immediately after the first assessment. Conclusion: Recovery time after electrical stimulation varies by threshold type and intensity of the stimuli. EST and EMT can be reliably reassessed immediately after sensory and motor stimulation, respectively. However, when stimulation reaches EPT level, EST requires 60 s to recover and EMT needs 90 s. EPT demonstrates higher variability, indicating the need for further investigation. These findings support the implementation of standardized recovery intervals in ETT and underscore the importance of interpreting EPT results with caution during rapid assessments.
(1) Background: The diagnosis of lumbosacral radiculopathy involves anamnesis, an assessment of sensitivity and strength, diagnostic imaging—usually magnetic resonance imaging (MRI)—and electrodiagnostic testing (EDX), typically electromyography (EMG), and electroneurography (ENG). MRI evaluates the structures supporting the spinal cord, while EDX evaluates root functionality. The present study aimed to analyze the concordance of MRI and EDX findings in patients with clinically suspected radiculopathy. Additionally, we investigated the comparison between these two reference tests and various clinical variables and questionnaires. (2) Methods: We designed a prospective epidemiological study of consecutive cases with an observational, descriptive, cross-sectional, and double-blind nature following the STROBE guidelines, encompassing 142 patients with clinical suspicion of lumbosacral radiculopathy. (3) Results: Of the sample, 58.5% tested positive for radiculopathy using EDX as the reference test, while 45.8% tested positive using MRI. The comparison between MRI and EDX in the diagnosis of radiculopathy in patients with clinical suspicion was not significant; the overall agreement was 40.8%. Only the years with symptoms were comparatively significant between the positive and negative radiculopathy groups as determined by EDX. (4) Conclusion: The comparison between lumbar radiculopathy diagnoses in patients with clinically suspected pathology using MRI and EDX as diagnostic modalities did not yield statistically significant findings. MRI and EDX are complementary tests assessing different aspects in patients with suspected radiculopathy; degeneration of the structures supporting the spinal cord does not necessarily imply root dysfunction.
15 July 2025 in Brazilian Journal of Physical Therapy
Physical fitness predicts health outcomes during childhood and later life. While the influence of obesity on physical fitness is well established, the impact of lower limb alignment (such as knee alignment, foot posture, and plantar footprint) on physical fitness has been less explored. To evaluate the relationship between lower limb alignment, body mass index (BMI), and physical fitness in children aged 10-12 with a sex-specific analysis. Fifty-nine children (33 girls, 26 boys) participated in this cross-sectional study. Knee alignment (genu valgum, normal), foot posture (using FPI-6), and plantar footprint (classified by the Hernández-Corvo method) were measured. BMI was calculated to classify children into underweight, normal weight, overweight, and obese. Physical fitness was assessed using the ALPHA-Fitness Test Battery, measuring cardiorespiratory fitness, muscular strength, and speed/agility. Multiple linear regression models were developed to analyse the associations between variables. Sex and BMI were significant predictors of muscular and cardiorespiratory fitness, with boys presenting better muscular and cardiorespiratory fitness. Larger BMI was associated with poorer muscular fitness (p = 0.003). Knee alignment in the frontal plane was not a predictive factor in physical fitness. Pronated foot was a weak predictor of lesser muscular fitness (p = 0.041). Plantar footprint did not significantly predict physical fitness. Sex and BMI were the main determinants of physical fitness. Despite some musculoskeletal factors having some influence, their relationship with physical fitness is not as direct as sex and BMI. Clinical practice should prioritise weight control in the interventions for physical fitness in children, considering sex differences.
20 September 2023 in Advances in Neurodevelopmental Disorders
Background: Hormonal fluctuations during the menstrual cycle (MC) influence pain perception, potentially affecting exercise performance and rehabilitation in women. This effect may be more pronounced in individuals with primary dysmenorrhea (PD), requiring tailored physiotherapeutic and exercise interventions. Objective: To analyze the influence of MC phases on sensory electrical threshold (SET) and pain electrical threshold (PET) in eumenorrheic women with and without PD, considering the potential implications for physical activity and rehabilitation. Methods: An observational longitudinal study was conducted with 34 physically active women, divided into a control group (CG) and a PD group. SET and PET were measured using transcutaneous electrical nerve stimulation (TENS) at the forearm (peripheral site) and lower abdomen (pain-referred site) across five MC phases. Pain intensity was assessed using a Visual Analog Scale (VAS). Results: SET and PET were significantly lower in the premenstrual phase (p < 0.001), suggesting increased pain sensitivity. VAS scores were higher in the PD group during all phases, except for the follicular phase (p < 0.033), with the highest pain levels recorded in the menstrual and premenstrual phases. While no significant differences in SET and PET were found between groups across most phases, the PD group exhibited a significantly higher SET in the forearm during the premenstrual phase (p = 0.005), potentially indicating altered central pain modulation. Conclusions: MC-related hormonal fluctuations affect pain sensitivity, particularly in women with PD. These findings underscore the need for phase-specific exercise adaptations and rehabilitation strategies to improve performance, pain management, and recovery in physically active women.