Lower Limb Neurodynamic Techniques | Sliders & Tensioners

Physiotutors
22 Feb 201904:41
EducationalLearning
32 Likes 10 Comments

TLDRThis video from PhysioTutors explores neurodynamic techniques for lower limb assessment and treatment, focusing on their effectiveness for low back pain patients. It demonstrates various techniques, including 'sliders' and 'tensioners', using an elastic tube to illustrate the concepts. The video highlights the importance of these methods in a home exercise program and provides a visual guide for correct execution, emphasizing the need for gentle stretching sensations or mild symptom provocation.

Takeaways
  • 📚 The video discusses neurodynamic techniques for the lower limb, with resources available in the description.
  • 🧠 Primary studies and systematic reviews have shown the effectiveness of neural mobilization for upper limbs.
  • 📈 Recent systematic reviews and meta-analysis by NATO et al. and Poisson et al. from 2017 suggest neural mobilization can reduce pain for low back pain patients.
  • 🔍 The meta-analysis found significant changes in pain, but the effects were just below the minimal clinically important difference, and many studies had a high risk of bias.
  • 🤔 The most common neurodynamic technique used in studies was neural mobilization in the slump or straight leg raise position.
  • 🏠 Patients were also instructed to perform these exercises as part of their home exercise program.
  • 📊 The video demonstrates the concept of sliders and tensioners using an elastic tube from the cervical spine to the foot.
  • 🧘‍♀️ For the slump slider, the video describes a sequence of movements starting from a slump position to extend the knee and neck.
  • 🧘 The slump tensioner involves starting in an upright sitting position and then performing a series of movements to tension the neural tissue.
  • 🦵 The straight leg raise slider and tensioner exercises are performed in a supine position with the leg elevated against a wall or similar surface.
  • 🤸‍♂️ A hybrid solution for the straight leg raise slider and tensioner can be done in a standing position using a rolling chair.
  • 💡 Both sliders and tensioners should be adjusted to create a gentle stretching sensation or evoke mild symptoms in rhythm with each oscillation.
Q & A

  • What is the main focus of the video?

    -The main focus of the video is to look at neurodynamic techniques for the lower limb.

  • Where can viewers find the assessment ebook and mobile app links?

    -The assessment ebook and mobile app links can be found in the video description.

  • What has been the subject of many primary studies and systematic reviews in relation to neural mobilization?

    -The effectiveness of neural mobilization of the upper limbs has been the subject of many primary studies and systematic reviews.

  • What recent systematic reviews and meta-analysis have investigated the effectiveness of neural mobilization for lower back pain?

    -Recent systematic reviews by NATO et al. and a meta-analysis by Poisson et al. from 2017 have investigated the effectiveness of neural mobilization for lower back pain.

  • What did the meta-analysis reveal about the changes in pain after neural mobilization compared to control interventions?

    -The meta-analysis revealed significant changes in pain after neural mobilization compared to control interventions, although the change remains just below the minimally clinically important difference in most studies.

  • What was the general risk of bias in the studies included in the meta-analysis?

    -Most studies included in the meta-analysis were at a high risk of bias.

  • What neurodynamic techniques were commonly used in the studies?

    -Most of the studies employed neural mobilization in the slump or straight leg raise position, which was also done by the patients as part of their home exercise program.

  • How is the concept of sliders and tensioners illustrated in the video?

    -The concept of sliders and tensioners is illustrated with the help of an elastic tube that is spanned from the cervical spine down to the foot.

  • What are the steps for performing a slump slider?

    -To perform a slump slider, one adopts a slump position, extends the knee, dorsiflexes the ankle, and extends the neck. Then, to slide the neural tissue, one approximately plantar flexes the ankle, flexes the knee, and flexes the neck.

  • How can a hybrid solution of sliders and tensioners be done in a standing position?

    -A hybrid solution can be done in a standing position using a rolling chair. The foot is placed on the chair, and a distal sliding technique is performed by rolling the chair away from the body while extending the knee and dorsiflexing the foot. Neck extension is added, and when returning to the starting position, neck flexion slides the neural tissue approximately.

  • What should be the outcome of performing sliders and tensioners?

    -Both the sliders and tensioners should be adjusted to elicit a gentle stretching sensation or to evoke mild symptoms in rhythm with each oscillation.

Outlines
00:00
🏃 Lower Limb Neurodynamic Techniques Overview

This paragraph introduces the video's focus on neurodynamic techniques for the lower limb. It mentions the availability of an assessment ebook and mobile app links in the video description. The video is part of the Physio Tutors series and discusses primary studies and systematic reviews on the effectiveness of neural mobilization for upper limbs. It highlights a meta-analysis that found significant, though just below the minimal clinically important difference, changes in pain for patients with low back pain following neural mobilization. The techniques used in most studies involved the slump or straight leg raise position, which were also part of patients' home exercise programs.

Mindmap
Keywords
💡neuro dynamic techniques
Neuro dynamic techniques are therapeutic methods used in physiotherapy to assess and treat neural tissues, such as nerves, by applying specific mobilizations. In the context of the video, these techniques are applied to the lower limb to address issues like lower back pain. The video discusses the effectiveness of such techniques based on primary studies and systematic reviews, highlighting their role in managing pain and improving neural mobility.
💡lower limb
The lower limb refers to the lower part of the human body, including the hips, thighs, knees, lower legs, ankles, and feet. In the video, the focus is on neuro dynamic techniques specifically for the lower limb, aiming to improve the function and reduce pain in these areas. The lower limb is a crucial aspect of the video as it is the primary area where the neuro dynamic techniques are applied.
💡assessment
Assessment in the context of the video refers to the evaluation process of a patient's neural tissues to determine the effectiveness of neuro dynamic techniques. It involves systematic reviews and primary studies to measure changes in pain and the potential for these techniques to be used in treatment plans. Assessment is vital for ensuring that the chosen therapeutic methods are beneficial and meet the clinical standards.
💡physio tutors
Physio tutors are instructors or educators in the field of physiotherapy who provide guidance and training to individuals seeking to learn about or practice physiotherapy techniques. In the video, 'Physio tutors' appears to be the name of the channel or organization producing the content, suggesting a focus on educational material for those interested in physical rehabilitation and its methodologies.
💡neural mobilization
Neural mobilization is a physiotherapy method that involves the application of gentle movements or mobilizations to the neural tissues to improve their mobility, reduce pain, and promote healing. The video discusses the effectiveness of neural mobilization in treating lower back pain and provides demonstrations of specific techniques for the lower limb.
💡systematic reviews
Systematic reviews are a type of research study that aims to identify, evaluate, and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question. In the video, systematic reviews are used to establish the evidence base for the effectiveness of neuro dynamic techniques in treating lower back pain, providing a structured approach to understanding the impact of these interventions.
💡minimally clinically important difference
The minimally clinically important difference (MCID) is a term used in healthcare research to describe the smallest change in a measurement that is considered to be of clinical significance to the patient. In the context of the video, it is mentioned to highlight that the changes in pain levels observed with neural mobilization techniques are just below this threshold, indicating that while there is improvement, it may not be significantly impactful for all patients.
💡home exercise program
A home exercise program (HEP) is a set of prescribed physical activities that patients are instructed to perform at home as part of their rehabilitation process. In the video, the HEP is mentioned as a way for patients to continue their treatment and practice neuro dynamic techniques, such as the 'slump' or 'straight leg raise' positions, to enhance their recovery and neural mobility.
💡sliders and tensioners
Sliders and tensioners are specific types of neuro dynamic techniques that involve the application of sliding or tension forces to neural tissues. Sliders involve moving the neural tissue along its path by changing the position of the body segments, while tensioners aim to create tension along the entire length of the nerve by stretching it. These techniques are used to improve neural mobility and reduce symptoms associated with nerve dysfunction.
💡elastic tube
An elastic tube is a type of therapeutic equipment used in physiotherapy to assist with exercises that involve dynamic stretching or resistance training. In the video, an elastic tube is used to demonstrate the concept of sliders and tensioners by attaching it from the cervical spine to the foot, providing resistance during the neuro dynamic techniques.
💡supine position
The supine position refers to lying on one's back with the face upwards. In the context of the video, the supine position is used as a starting point for certain neuro dynamic techniques, such as the 'straight leg raise slider,' where the patient lies down with one leg elevated against a wall or similar supporting surface to perform the sliding motion on the neural tissue.
💡rolling chair
A rolling chair is a type of chair with wheels that allows for movement across a surface. In the video, a rolling chair is used as a tool in the demonstration of a hybrid neuro dynamic technique for the lower limb. The chair facilitates the distal sliding technique by rolling away from the patient, which helps in applying the sliding motion to the neural tissue.
Highlights

The video discusses neurodynamic techniques for lower limb.

An assessment ebook and mobile app links are provided in the video description.

Primary studies and systematic reviews have been conducted on the effectiveness of neural mobilization of the upper limbs.

Recent systematic reviews and meta-analysis reveal significant changes in pain with neural mobilizations for lower back pain treatment.

The change in pain is just below the minimally clinically important difference in most studies.

Most studies were at a high risk of bias.

Neural mobilization in the slump or straight leg raise position was commonly used.

Patients also performed these exercises as part of their home exercise program.

The concept of sliders and tensioners is illustrated with the help of an elastic tube.

The video demonstrates how to perform a slump slider and tensioner.

For the straight leg raise slider, the patient is in a supine position with the leg elevated.

A hybrid solution using a rolling chair in a standing position is presented.

Distal sliding techniques are performed by rolling the chair away and extending the knee.

Both sliders and tensioners should elicit a gentle stretching sensation or mild symptoms.

The video is part of a series on neurodynamic techniques by PhysioTutors.

The video concludes with a call to action for viewers to subscribe to the channel and watch related content.

Transcripts

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Neuro MobilizationLower LimbPhysio TutorialsTherapy TechniquesBack PainEvidence-BasedClinical PracticeExercise ProgramsHealthcare Education