Preparatory use of neurodynamics to enhance upper limb function in patients with acquired brain injury: a randomized controlled trial

Recent studies on neurodynamics have shown beneficial effects on the musculoskeletal system and peripheral nerve physiology. Hence, the application of neurodynamics in people who have suffered an acquired brain injury has the potential to improve their functionality to perform daily activities. This study aimed to assess the immediate effects of a single session of median nerve neurodynamics versus a placebo intervention on the affected upper limb (UL) in patients with acquired brain injury (ABI). A single-blind randomised clinical trial was conducted with 24 participants, divided into an experimental group (n = 12) and a control group (n = 12. Outcomes measures included grip strength (dynamometer), spasticity (Modified Ashworth Scale), pain (algometer and Visual Analogue Scale), range of motion (goniometer), and surface electromyography. Statistically significant improvements were observed in the experimental group in terms of reduced spasticity in the triceps and carpal flexors, and increased wrist flexion and extension range of motion. Additionally, modulation of muscle activity was detected in the triceps, biceps, and wrist flexors and extensors. In contrast, changes in grip strength and pain perception were not statistically significant. Although a downward trend in grip strength was noted in both groups, this observation should be interpreted cautiously and does not imply a therapeutic benefit without further functional corroboration. These findings suggest that neurodynamics may produce short-term neuromuscular effects in ABI patients, particularly in muscle tone and joint mobility. However, further research is needed to determine the clinical relevance and sustainability of these effects.Clinical trial registration number: Clinicaltrials.gov (NCT04652934). Date of first trial registration 03/12/2020.