Effect of a Cervical Lateral Glide on the Upper Limb Neurodynamic Test 1

BACKGROUND AND PURPOSE\nThis study investigated the effect of the cervical lateral glide technique applied at the facet joint between the fifth and sixth cervical vertebrae, on the range of elbow extension, a component of the upper limb neurodynamic test 1. \n\nMETHOD\nTwenty asymptomatic subjects, naïve to the effects of manual therapy, were randomly allocated to a varied order of procedures that included cervical lateral glide technique, placebo technique, and control procedure. Elbow extension range was measured with an electrogoniometer before and after each procedure. The lead investigator was blinded to the data output. A pilot study before the main investigation established the reliability and accuracy of measuring elbow extension range with the electrogoniometer. \n\nRESULTS\nThe results of a Friedman's analysis of variance suggested that there was a significant difference between the three conditions (p <0.0001). Results of multiple comparison analysis using the Wilcoxon signed rank test suggested that the cervical lateral glide technique resulted in a change in elbow extension over 7° (p <0.001) where minimal change occurred in the placebo and control conditions. \n\nCONCLUSIONS\nThe cervical lateral glide technique applied to the facet joint between the fifth and sixth cervical vertebrae significantly increased the elbow extension component of the upper limb neurodynamic test 1 in asymptomatic subjects, compared with those receiving a placebo technique and a control group. It is hypothesised that two mechanisms may have led to this increase. The first involves a change to the nerve root interface at the cervical intervetebral foramen. The second is that the cervical lateral glide technique reduced the tone of muscles supplied by the mobilised segment resulting in the observed increase in elbow extension.