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Maria Alice Mainenti Pagnez1, Leticia Amaral Corrêa2, Renato Santos Almeida3

  • 1Physiotherapy Department, Rehabilitation Science Postgraduate Program, Augusto Motta University Centre, Rio de Janeiro, Brazil; Academic Department, Madrid School of Osteopathy, Rio de Janeiro, Brazil.

Journal of Manipulative and Physiological Therapeutics
|April 29, 2019
PubMed
Summary

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This summary is machine-generated.

Flexing the knee and keeping the ankle neutral increased sciatic nerve cross-sectional area during spinal manipulation. Knee extension with ankle dorsiflexion reduced it.

Area of Science:

  • Biomedical Engineering
  • Neuroscience
  • Radiology

Background:

  • Spinal manipulation techniques, such as flexion-distraction, are used in treating various neuromusculoskeletal conditions.
  • Understanding the biomechanical effects of these techniques on peripheral nerves is crucial for optimizing treatment and preventing adverse events.
  • The sciatic nerve's cross-sectional area (CSA) can be influenced by body positioning and mechanical forces.

Purpose of the Study:

  • To compare the cross-sectional area (CSA) of the sciatic nerve under six different positioning variations of the flexion-distraction technique.
  • To investigate how lumbar, knee, and ankle positions affect sciatic nerve CSA during spinal manipulation.

Main Methods:

  • Thirty healthy participants underwent ultrasound imaging to measure the sciatic nerve's CSA in the posterior medial thigh.
Keywords:
Lumbosacral PlexusManipulation, OsteopathicPhysical Therapy ModalitiesUltrasonography

Related Experiment Videos

  • Measurements were taken in six distinct flexion-distraction positions, varying lumbar (neutral vs. flexed), knee (extended vs. flexed), and ankle (neutral vs. dorsiflexed) configurations.
  • Statistical analysis compared CSA values across the different positions.

    • Main Results:

    • Position B (lumbar neutral, knee flexed, ankle neutral) showed a significantly higher mean sciatic nerve CSA (59.71 ± 17.41 mm²) compared to positions D (lumbar flexed, knee extended, ankle neutral; 51.18 ± 13.81 mm²; P = .005), F (lumbar flexed, knee extended, ankle dorsiflexed; 48.71 ± 15.16 mm²; P = .004), and C (lumbar neutral, knee extended, ankle dorsiflexed; 48.37 ± 16.35 mm²; P = .009).
    • A total of 180 ultrasound images were analyzed.
    • Specific combinations of knee and ankle positions demonstrated significant differences in nerve CSA.

    Conclusions:

    • Flexing the knee while maintaining a neutral ankle position appears to increase the sciatic nerve's cross-sectional area during flexion-distraction.
    • Conversely, combining knee extension with ankle dorsiflexion reduces the sciatic nerve's CSA.
    • These findings suggest that specific patient positioning during spinal manipulation can modulate sciatic nerve biomechanics.