The Variation of Cross-Sectional Area of the Sciatic Nerve in Flexion-Distraction Technique: A Cross-Sectional Study |
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| Affiliation: | 1. Physiotherapy Department, Rehabilitation Science Postgraduate Program, Augusto Motta University Centre, Rio de Janeiro, Brazil;2. Academic Department, Madrid School of Osteopathy, Rio de Janeiro, Brazil;3. Physiotherapy Department, Serra dos Órgãos University Centre, Teresópolis, Brazil;4. Musculoskeletal Health Sydney, School of Public Health, The University of Sydney New South Wales, Australia;5. Physiotherapy Department, Federal Institute of Rio de Janeiro, Rio de Janeiro, Brazil;1. Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada;2. Department of Medicine, University of Alberta, Edmonton, Alberta, Canada;3. Sydney Medical School, University of Sydney, Sydney, Australia;4. Department of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada;5. AECC University College, Bournemouth, England;6. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong;1. Researcher, IRCCS Don Gnocchi Foundation, Milan, Italy;2. Physical Therapist, Associate Professor, Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy;3. Researcher, Mechanical and Industrial Engineering Department. University of Brescia, Brescia, Italy;1. Private practice, Somerset, New Jersey.;2. Department of Neurosurgery, Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey |
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| Abstract: | ObjectiveThe purpose of this study was to compare the cross-sectional area of the sciatic nerve in different positions of spinal manipulation using flexion-distraction technique.MethodsThirty healthy participants were assessed in 6 different flexion-distraction technique positions of varying lumbar, knee, and ankle positions. Participants stood in the following 3 positions with the lumbar in the neutral position: (A) with knee extended, (B) with knee flexed, and (C) with the knee extended and ankle dorsiflexion. Participants then stood in the following 3 positions with the lumbar flexed: (D) with the knee extended, (E) with the knee flexed, and (F) with knee extended and ankle dorsiflexion. The cross-sectional area (CSA) of the sciatic nerve was measured with ultrasound imaging in transverse sections in the posterior medial region of the left thigh. The CSA values measured at each position were compared.ResultsWe analyzed 180 ultrasound images. The cross-sectional area of the sciatic nerve (in mm2) in position B (mean; standard deviation) (59.71-17.41) presented a higher mean cross-sectional area value compared with position D (51.18-13.81; P =.005), position F (48.71-15.16; P = .004), and position C (48.37-16.35; P = .009).ConclusionThe combination of knee extension and ankle dorsiflexion reduced the CSA of the sciatic nerve, and flexing the knee and keeping the ankle in the neutral position increased it. |
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