Upper Limb Tension (neurodynamic) Test 2A – Median Nerve, Musculocutaneous Nerve, and Axillary Nerve Root Bias
Purpose of Upper Limb Tension Test 2A: To determine if the tension along the median/musculocutaneous/axillary 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:
- Shoulder girdle/Scapular depression (using the examiner’s thigh closer to the patient),
- Shoulder abduction up to 10 degrees (with the examiner’s one hand around patient’s elbow and the other hand around patient’s wrist),
- Elbow extension,
- Shoulder external rotation,
- Forearm supination,
- Wrist extension,
- Fingers and thumb extension,
- 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:
- 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.
- Kleinrensink GJ, Stoeckart R, Vleeming A, Snijders CJ, Mulder PGH. Mechanical tension in the median nerve. The effects of joint positions. Clinical Biomechanics. 1995;10(5):240-4.