A Study of Comparison between the Immediate and Lasting Effects of Slider and Tensioner Neurodynamic Techniques on Knee Extension Range of Motion and Pain in the Slump Position

Background: In-vitro microscopic studies on nerve have shown adverse effects of tension on vascularity and conduction. Slider neurodynamic technique involves sliding of nerve without producing tension while tensioner involves elongation of entire nerve tract i.e. it produces tension. In view of potential negative effects of tension on vascularity and conduction, tensioner technique may have adverse effects or it may reduce the therapeutic benefits. Also owing to visco-elastic nature of neural tissue, understanding the lasting effect of these techniques will help in deciding frequency of treatment.

Purpose: Therefore, purpose of this study was to compare the immediate and lasting effects of slider and tensioner neurodynamic techniques on knee extension range and pain intensity during slump test in normal population.

Study design: Prospective comparative study.

Method: Slump test was performed on 110 normal asymptomatic subjects who demonstrated normal neurogenic response to slump test (17- 25yrs; slider group-55, tensioner group-55). Subjects in slider and tensioner group performed 10 repetitions of slider and tensioner neurodynamic techniques respectively in 2 minutes on first day. Knee extension range and pain intensity on VAS at 'onset of pain' and at 'pain tolerance' during slump test were measured in pre-intervention period and re-measured in immediate post, on 2nd day post and 1 week post intervention periods.

Results: Repeated measures Anova and Freidmann test showed significant improvement in knee extension range and pain intensity respectively during slump test in immediate post intervention period only in both groups. No significant difference was found on 2nd day and 1week post intervention periods. Comparison between the two groups showed statistically non-significant trend in knee extension range by unpaired t-test and pain intensity by Mann Whitney-u test on all days of assessment.

Conclusion: Both slider and tensioner techniques have positive and significant effect on improving knee extension range and pain intensity in slump position in normal asymptomatic subjects. Both the techniques are effective only in immediate intervention period with no carry over effect.