Effects Of Neurodynamics on Spasticity in Upper Extremity of Stroke Patients

Neurodynamics of Spasticity in Upper Extremity of Stroke Patients


  • Nafeesa Zamurd Riphah International University Islamabad
  • Mirza Obaid Baig Riphah International University Islamabad
  • Aamir Gul Memon Riphah International University Islamabad
  • Muhammad Khan Bugti Begum Nusrat Bhutto University Sukkur
  • Mazhar Ali Butto Sindh Govt Civil Hospital Khairpur
  • Maryam Sulaiman Comwave Institute of Science & Information Technology
  • Umar Shakoor University Of Lahore Gujrat Campus
  • Amber Shakoor University Of Lahore Gujrat Campus
  • Muhammad Adnan Physiotherapist Khyber Teaching Hospital Peshawar
  • Saman Jahangir Shaheed Zulfiqar Ali Bhutto Medical University




Neurodynamic, spasticity, stroke.


Stroke leads to long term disability and spasticity is one of them. Neurodynamic is a movement which aimed to restore the electrical signal directed to the nerve and the spinal cord. The neural mobilization is used to restore the movement and improve elasticity of nervous system to improve the arm function and regain the motor ability in patients with stroke.  Objective: To assess the effects of neurodynamics on spasticity in upper extremities of stroke patients. Methods: It is a Randomized controlled trial. Data was collected from 46 stroke Patients. Simple Random Sampling was done and data was collected from District headquarters hospital (DHQ) Jhelum. Patients with chronic stroke, age 40-60 years, Modified Ashworth Scale (MAS) ≥1 to 3 and both male and female were included in this study. For 6 weeks, the experimental group received conventional therapy with neurodynamics (10 reps/ set, 1 set/ day, 3 days/week), whereas the control group received conventional treatment (12 reps/ set, 1 set/ day, 3 days/week). The MAS, Fugl Meyer Upper Extremity Scale (FMUE), goniometry and Action Research Arm Test were used to examine the participants at zero, three, and six weeks (ARAT). The Shapiro-Wilk test was used to ensure that the data was normal, and statistical analysis was performed using SPSS 21. Results: Statistically significant improvement was found in between group analyses in MAS, FM-UE motor score and AROM as the p-value was <0.05. There was no significant difference in ARAT, FM-UE sensation, joint pain, passive joint motion, coordination and PROM as p-value was >0.05. Statistically significant improvement was found in within group analyses in MAS, FM-UE motor score, sensation, joint pain, AROM and PROM as the p-value was <0.05 except in ARAT and FM-UE coordination. Conclusion: The result shows that neurodynamic combined with conventional treatment was more effective than conventional treatment alone to reduce spasticity, improve upper extremity function and AROM. The result also shows that there was significant improvement in upper extremity joint pain, sensation and PROM and no improvement occurred in coordination and fine task performance within groups. The study concludes that neurodynamic is effective for spasticity and has additional benefit in improving UE functional performance and active range of motion but the effects of neurodynamic combined with conventional treatment are no different than conventional treatment alone on passive range of motion, joint pain, coordination, fine task performance and sensation.


Saxena A, Sehgal S, Jangra MK. Effectiveness of Neurodynamic Mobilization versus Conventional Therapy on Spasticity Reduction and Upper Limb Function in Tetraplegic Patients. Asian Spine Journal. 2021 Aug;15(4): 498.doi.org/10.31616/asj.2020.0146

Nery dos Santos AC, Gusmão de Goes AC, Lago RMV, et al. Neural mobilization as a therapeutic option in the treatment of stroke. Man Ther. 2016; 14(310):1-4. doi.org/10.17784/mtprehabjournal.2016.14.310

De Lima KCS, Piauilino PMM, Franco RM, et al. Effect of muscle stretching, neural mobilization and vibration in patients with stroke. ConScientiae Saúde. 2016;15(1):62-70. doi.org/10.5585/conssaude. v15n1.5861

Lee EK, Kim JH, Lee JH, Cho EB. Research trends and clinical applications of neural mobilization in Korea: A scoping review. The Journal of Korea CHUNA Manual Medicine for Spine and Nerves. 2021;16(1):53-66. doi.org/10.30581/jcmm.2021.16.1.53

Mallmann JS et al. Prevenção de hipotrofia muscular pelo uso da mobilização neural em modelo experimental de ciatalgia. Revista Brasileira de Fisiologia do Exercício. 2012; 11(1):13-6. doi.org/10.33233/rbfe. v11i1.3374

Zamberlan AL et al. Mobilização neural Como um recurso fisioterapêutico na reabilitação de pacientes com acidente vascular encefálico – revisão. Revista Salus-Guarapuava. 2007; 1(2):185-91.

Machado GF, Bigolin SE. Estudo comparativo de casos entre a mobilização neural e um programa de alongamento muscular em lombálgicos crônicos. Fisioter Mov. 2010; 23(4): 545-54.doi.org/10.1590/S0103-51502010000400005

Véras LST, Vale RGS et al. Avaliação da dor em portadores de hanseníase submetidos à mobilização neural. Fisioter Pesq. 2011; 18(1):31-6 doi.org/10.1590/S1809-29502011000100006

Kim MJ, Kim TH. Effect of Neuro Dynamic Technique and Instrument Assisted Soft Tissue Mobilization on Lower Extremity Muscle Tone, Stiffness, Static Balance in Stroke Patients. The Journal of Korean Physical Therapy. 2020;32(6):359-64.

Vladimirovna KE, Vladimirovna PL, Vasilyevich RA. Post-Stroke Motor Impairments: The Possibilities of Innovative Technologies and The Results of the Own Research. International Journal of Innovative Medicine. 2022;(1):4-10.

Suhail M, Prakash A, Sonali D, Sangeeta M. Effectiveness of dynamic soft tissue mobilization vs passive stretching to improve hamstring flexibility in stroke patients–A comparative study.

Kang JI, Moon YJ, Jeong DK, Choi H, Park JS, Choi HH. Muscle activity in relation to the changes in peripheral nerve conduction velocity in stroke patients: Focus on the dynamic neural mobilization technique. Journal of International Academy of Physical Therapy Research. 2018;9(2):1447-54.

Li F, Jiang L, Zhang Y, Huang D, Wei X, Jiang Y, et al. The time-varying networks of the wrist extension in post-stroke hemiplegic patients. Cognitive Neurodynamics. 2021 Nov; 2:1-0.

de Lima Souza R, Moriz KR, Teixiera FD, Fernandes AA, da Costa Neto SS, De Oliveira MD, et al. Effect of neural mobilization on balance, flexibility, strength and gait in stroke patients. Manual Therapy, Posturology & Rehabilitation Journal. 2018:1-5.

Alan Carlos Nery dos Santos et al, The effects of neural mobilization as a therapeutic option in the treatment of stroke, MTP and Rehab journal 2017, ISSN 2236-5435

Lundquist et al. The Fugl-Meyer assessment of the upper extremity: reliability, responsiveness and validity of the Danish version, Disabil Rehabil, 2017 May; 39(9):934-939.

McClure P, Tevald M, Zarzycki R, Kantak S, Malloy P, Day K, et al. The 4-element movement system model to guide physical therapist education, practice, and movement-related research. Physical Therapy. 2021 Mar;101(3):pzab024.

Raid Saleem Al Baradie et al. The effects of Neurodynamics and mobilization in Stroke Rehabilitation– a Systematic Review, Majmaah Journal of Health Sciences 2017; Vol.5, issue 2.

Mac Kenzie DE. Investigating Influences on the Current Trends in Occupational and Physical Therapy Management of Clients Experiencing Spasticity (Doctoral dissertation, Mount Saint Vincent University)

Beschi M, Pth CV, Orth MZ, Orth MP, Orth GF, Orth AM. Jacobs Journal of Physical Rehabilitation Medicine.



DOI: 10.54393/pbmj.v5i5.443
Published: 2022-05-31

How to Cite

Zamurd , N., Obaid Baig , M. ., Gul Memon , A. ., Khan Bugti , M. ., Ali Butto, M. ., Sulaiman , M. ., Shakoor , U. ., Shakoor , A. ., Adnan , M. ., & Jahangir, S. (2022). Effects Of Neurodynamics on Spasticity in Upper Extremity of Stroke Patients: Neurodynamics of Spasticity in Upper Extremity of Stroke Patients. Pakistan BioMedical Journal, 5(5), 257–262. https://doi.org/10.54393/pbmj.v5i5.443



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