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Immediate effects of longitudinal vs. Transverse tibial nerve massage on vibration perception thresholds and thermal perception thresholds in asymptomatic subjects: A pilot randomized clinical trial (UTRN 014427448-2101200878203)

Kumar P.S , Kumar P.S , Adhikari P , Jeganathan P.S.

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Physiotherapy and Occupational Therapy Journal 3(1):p 13-23, January - March 2010. | DOI:

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Abstract

Purpose of study: To compare the immediate effects of two techniques of nerve massage- longitudinal and transverse, for tibial nerve on the vibration and temperature thresholds in the foot in asymptomatic subjects. Materials and methods: 48 subjects of either sex (34 male, 14 female), with mean age 23.6 ± 4.8 years, volunteered to participate by incidental sampling after giving informed consent. The side of the leg for first intervention was chosen by simple random sampling and the choice of first intervention (longitudinal or transverse nerve massage) was allocated in a concealed manner using block randomization. One intervention was a longitudinal nerve massage (to either side) while other was a transverse nerve massage (to the other side). One tester administered the nerve massage techniques while an independent blinded observer measured the outcome measures. Both the interventions lasted for 2 minutes each. The techniques were applied for 10 reps and 2 sets. Pre, immediate post intervention and post intervention- 5 mins assessment of vibration thresholds, heat thresholds and cold thresholds of the sole of the foot were assessed using a Vibrotherm® (Biothesiometer) by the blinded observer.Results: Tibial nerve transverse massage technique reduced the vibration thresholds (2.1± .84 volts) in the foot significantly better (p=.000) than that of the longitudinal nerve massage. Transverse massage technique also reduced the heat thresholds- 6.4 ± 1.8 degrees Celsius (p=.054) and increased the cold thresholds- 4.8 ± 2.2 degrees Celsius (p=.87) clinically but not statistically significant (p >.05). Both effects were however reversible within five minutes (p <.05). There was no effect of side of dominance (p=.14) in all the subjects studied. Conclusion: Transverse nerve massage technique was significantly better than the longitudinal massage technique in reducing the vibration thresholds for tibial nerve. Clinically, transverse nerve massage technique also reduced the heat thresholds and increased the cold thresholds for tibial nerve in the subjects studied.

Keywords: Neurodynamics, nerve massage, quantitative sensory testing, randomized controlled trial.

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