ニューロリハビリテーションの国際ジャーナル

Neurodynamic Mobilization and Peripheral Nerve Regeneration: A Narrative Review

Abstract

Herman Henrique Silva Santana, Iasmyn Adélia Victor Fernandes de Oliveira, Êmyle Martins Lima, Alena Ribeiro Alves Peixoto Medrado, Katia Nunes Sá, Ana Maria Blanco Martinez, Abrahão Fontes Baptista

After a peripheral nerve injury, various aspects, including mechanical nerve properties, will influence regeneration. The reduction of nerve viscoelasticity, intraneural edema, mechanosensitivity, and adhesion of neural tissue to its interfaces may be a target to approaches that impose graded mechanical loads to the nerve. However, the effects of those treatments on peripheral nerve regeneration are not clear. Particularly neurodynamic mobilizations may be very useful. They consist of therapeutic maneuvers to assess nerve mechanical properties and restore their function through graded movements of the peripheral nerve attachments to bones and muscles. Here we discuss theoretical and experimental data regarding the effects of graded mechanical loads on peripheral nerve function and regeneration, and propose how neurodynamic mobilizations would interact with the peripheral nerve in order to promote regeneration. Those effects would influence the reduction of edema, normalization of axoplasmic flow, decrease nerve mechanosensitivity, and promotion of appropriate nerve mobility, increasing glial and neuronal activity.