HOW TO ASSESS NEUROLOGICAL INTEGRITY
If you want to learn more about this topic, you can watch Colette Ridehalgh's lecture here:
Here are 4 important things to assess neurological integrity:
1. SENSATION
a) Light touch: Ideally light touch is assessed using a cotton wool. The patient is instructed to close his eyes and the dermatomes are tested by lightly touching them.
b) Pin prick :It is assessed by using a neurotip or a safety pin. The pain response is checked in the same manner as light touch.
c) Warm and cold: It can be assessed using test tubes with water if available. The water should be just warm and just cold and not too extreme. Coins can also be used , which can be warmed up prior to applying on the skin.
2. MUSCLE STRENGTH
Muscle strength can be assessed isometrically, ideally in mid-range and working through the myotomes.
3. TENDON REFLEXES
We’re looking at a monosynaptic reflex, so we’re getting both afferent and efferent response to that reflex and we’re looking for the influence of the higher centers. Normally we would have some inhibition of that reflex, and if there’s a situation where there’s some kind of central nervous system pathology, we don’t get that inhibition and we would get a heightened reflex.
4. NEURODYNAMIC TESTS
These are tests to assess abnormal amount of heightened nerve mechanosensivity.
A test is positive when:
- Symptoms are reproduced
- Structural differentiation changes symptoms
- Rom may be different but not sufficient alone
Watch this clip to know more about neurodynamic tests.
If you want to learn more about this topic, you can watch Colette Ridehalgh's lecture here:
Sources:
1. Lecture 'Nerve Related Musculoskeletal Pain’ by Dr Colette Ridehalgh
