Upper Limb Tension (neurodynamic) Test 2B – Radial Nerve Bias

Purpose of Upper Limb Tension Test 2B: To determine if the tension along the radial nerve course contributes to neurologic symptoms associated with cervical radiculopathy.

Patient position: Supine lying.

Examiner position: Standing beside the examination table, facing the patient’s legs, at the side of the limb to be tested.

Procedure: Perform the joint positioning sequence in the following order:

1. Shoulder internal rotation (with the examiner’s one hand around the patient’s elbow and the other hand around the patient’s wrist),
2. Shoulder girdle/Scapular depression (using the examiner’s thigh closer to the patient),
3. Elbow extension,
4. Shoulder internal rotation (to the end of the available range),
5. Forearm pronation,
6. Wrist flexion and ulnar deviation,
7. Fingers and thumb flexion,
8. Sensitizing position: Contralateral or Ipsilateral cervical spine lateral flexion.

Outcome: This test is positive if (a) the limb/joint positioning sequence reproduces symptoms associated with radiculopathy, (b) the sensitizing position reproduces symptoms, and (c) there is a repeatable and measurable asymmetry between both sides along with the reproduction of symptoms.

Reference:

1. Kleinrensink GJ, Stoeckart R, Mulder PG, Hoek G, Broek T, Vleeming A, et al. Upper limb tension tests as tools in the diagnosis of nerve and plexus lesions. Anatomical and biomechanical aspects. Clinical biomechanics (Bristol, Avon). 2000;15(1):9-14.
2. Petersen SM, Covill LG. Reliability of the radial and ulnar nerve biased upper extremity neural tissue provocation tests. Physiotherapy Theory and Practice. 2010;26(7):476-82.