The Immediate Effect of Thoracic High Velocity Low Amplitude Thrust on the Upper Limb Neurodynamic Test 1 in an Asymptomatic Population- A Randomized Control Trial



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Objectives: The objective of this study was to determine the immediate effect of thoracic spine high velocity low amplitude thrust (HVLAT) manipulation on upper extremity neural tension by using the upper limb nerve tension test 1 (ULNTT1) in asymptomatic participants.
Design: A single-blinded, randomized, pretest-posttest design was utilized. Methods: Block assignment was used to randomly allocate 33 asymptomatic participants (mean age 25 years) into either the experimental group, T-6 P-A HVLAT, or control group, lying supine for 5 minutes. A pre and post ULNTT1 were completed on each participant noting the participant’s first self-perceived onset of discomfort or tingling (R1) and when the participant requested the test to be stopped (R2). Outcome Measures: The outcome measures used for this study were elbow range of motion using an electronic goniometer during the ULNTT1 for the participant’s self reported R1 and R2.
Results: The repeated measures ANOVA revealed a significant group to time interaction for R2 (p = 0.03). In the experimental group there was an increase in mean elbow extension of 6.7° compared to 1.6° in the control group. R1 failed to obtain a significant group to time interaction (p = .117). There was a trend towards significance with a mean increase in elbow extension of 5.9° in the experimental group compared to 0.57° in the control.
Conclusion: Our findings indicate that thoracic HVLAT has an immediate effect on decreasing upper limb neural tension in asymptomatic participants.



upper limb nerve tension test, thoracic manipulation, spinal manipulation, regional interdependence, adverse neural tension