Structure and biomechanics of peripheral nerves: Nerve responses to physical stresses and implications for physical therapist practice

Physical Therapy

Volumn 86, Issue 1, 2006, Pages 92-109

  Topp, Kimberly S ^a   Boyd, Benjamin S ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

Adaptation; Compression; Excursion; Force; Inflammation; Neurodynamics; Physiology; Plasticity; Sprains and strains; Stress

Indexed keywords

ADAPTATION; BIOMECHANICS; DAILY LIFE ACTIVITY; HUMAN; INFLAMMATION; NERVE COMPRESSION; NERVE POTENTIAL; NEUROMUSCULAR SYNAPSE; PERIPHERAL NERVE; PHYSICAL STRESS; PHYSIOTHERAPY; PLASTICITY; REVIEW; SPRAIN; TENSILE STRENGTH; ULNAR NERVE;

EID: 29744470035     PISSN: 00319023     EISSN: None     Source Type: Journal    
DOI: 10.1093/ptj/86.1.92     Document Type: Review

References (103)

1. Shacklock M. Neurodynamics. Physiotherapy. 1995;81:9-16.
2. Mueller M, Maluf K. Tissue adaptation to physical stress: a proposed "physical stress theory" to guide physical therapist practice, education, and research. Phys Ther. 2002;82:383-403.
3. Thomas P. The connective tissue of peripheral nerve: an electron microscope study. J Anat. 1963;97:35-44.
4. Gamble H, Eames R. An electron microscope study of the connective tissues of human peripheral nerve. J Anat. 1964;98:655-663.
5. Schiff R, Rosenbluth J. Ultrastructural localization of laminin in rat sensory ganglia. J Histochem Cytochem. 1986;34:1691-1699.
6. Shanthaveerappa T, Bourne G. The "perineural epithelium," a metabolically active, continuous, protoplasmic cell barrier surrounding peripheral nerve fasciculi. J Anat. 1962;96:527-537.
7. Rechthand E, Rapoport S. Regulation of the microenvironment of peripheral nerve: role of the blood-nerve barrier. Prog Neurobiol. 1987;28:303-343.
8. Sunderland S, Bradley K. The cross-sectional area of peripheral nerve trunks devoted to nerve fibres. Brain. 1949;72:428-449.
9. Sunderland S, Bradley K. Stress-strain phenomena in denervated peripheral nerve trunks. Brain. 1961;84:125-127.
10. Rydevik B, Kwan M, Myers R, et al. An in vitro mechanical and histological study of acute stretching on rabbit tibial nerve. J Orthop Res. 1990;8:694-701.
11. Stolinski C. Structure and composition of the outer connective tissue sheaths of peripheral nerve. J Anat. 1995;186:123-130.
12. Sunderland S. The anatomy and physiology of nerve injury. Muscle Nerve. 1990;13:771-784.
13. Sunderland S. The intraneural topography of the radial, median, and ulnar nerves. Brain. 1945;68:243-299.
14. Sunderland S. The intraneural topography of the sciatic nerve and its popliteal divisions in man. Brain. 1948;71:242-273.
15. Millesi H, Zoch G, Reihsner R. Mechanical properties of peripheral nerves. Clin Orthop Relat Res. 1995;314:76-83.
16. Sunderland S. The connective tissues of peripheral nerves. Brain. 1965;88:841-854.
17. Appenzeller O, Dhital K, Cowen T, Burnstock G. The nerves to blood vessels supplying blood to nerves: the innervation of vasa nervorum. Brain Res. 1984;304:383-386.
18. Rechthand E, Hervonen A, Sato S, Rapoport S. Distribution of adrenergic innervation of blood vessels in peripheral nerve. Brain Res. 1986;374:185-189.
19. Burkel W. The histological fine structure of perineurium. Anat Rec. 1967;158:177-189.
20. Bell G, Weddell A. A descriptive study of the blood vessels of the sciatic nerve in the rat, man and other mammals. Brain. 1984;107:871-898.
21. Bell M, Weddell A. A morphometric study of intrafascicular vessels of mammalian nerve. Muscle Nerve. 1984;7:524-534.
22. Dyck P, Giannini C, Lais A. Pathological alterations of nerves. In: Dyck P, Thomas P, Griffin J, et al, eds. Peripheral Neuropathy. 3rd ed. Philadelphia, Pa: WB Saunders Co; 1993:515-595.
23. Abrams R, Butler J, Bodine-Fowler S, Botte M. Tensile properties of the neurorrhaphy site in the rat sciatic nerve. J Hand Surg Am. 1998;23:465-470.
24. Beel J, Groswald D, Luttges M. Alterations in the mechanical properties of peripheral nerve following crush injury. J Biomech. 1984;17:185-193.
25. Driscoll P, Glasby M, Lawson G. An in vivo study of peripheral nerves in continuity: biomechanical and physiological responses to elongation. J Orthop Res. 2002;20:370-375.
26. Toby E, Hanesworth D. Ulnar nerve strains at the elbow. J Hand Surg Am. 1998;23:992-997.
27. Wright T, Glowczewski FJ, Wheeler D, et al. Excursion and strain of the median nerve. J Bone Joint Surg Am. 1996;78:1897-1903.
28. Byl C, Puttlitz C, Byl N, et al. Strain in the median and ulnar nerves during upper-extremity positioning. J Hand Surg Am. 2002;27:1032-1040.
29. Dilley A, Lynn B, Greening J, DeLeon N. Quantitative in vivo studies of median nerve sliding in response to wrist, elbow, shoulder and neck movements. Clin Biomech. 2003;18:899-907.
30. McLellan D, Swash M. Longitudinal sliding of the median nerve during movements of the upper limb. J Neurol Neurosurg Psychiatry. 1976;39:566-570.
31. Erel E, Dilley A, Greening J, et al. Longitudinal sliding of the median nerve in patients with carpal tunnel syndrome. J Hand Surg Br. 2003;28:439-443.
32. Smith S, Massie J, Chesnut R, Garfin S. Straight leg raise: anatomical effects on the spinal nerve root without and with fusion. Spine. 1993;18:992-999.
33. Wright T, Glowczewski F, Cowin D, Wheeler D. Ulnar nerve excursion and strain at the elbow and wrist associated with upper extremity motion. J Hand Surg Am. 2001;26:655-662.
34. Boyd BS, Puttlitz C, Gan J, Topp KS. Strain and excursion in the rat sciatic nerve during a modified straight leg raise are altered after traumatic nerve injury. J Orthop Res. 2005;23:764-770.
35. Kleinrensink G, Stoeckart R, Vleeming A, et al. Mechanical tension in the median nerve: the effects of joint position. Clin Biomech. 1995;10:240-244.
36. Haftek J. Stretch injury of peripheral nerve: acute effects of stretching on rabbit nerve. J Bone Joint Surg Br. 1970;52:354-365.
37. Kwan M, Wall E, Massie J, Garfin S. Strain, stress and stretch of peripheral nerve: rabbit experiments in vitro and in vivo. Acta Orthop Scand. 1992;63:267-272.
38. Pourmand R, Ochs S, Jersild R Jr. The relation of the beading of myelinated nerve fibers to the bands of Fontana. Neuroscience. 1994;61:373-380.
39. Walbeehm E, Afoke A, de Wit T, et al. Mechanical functioning of peripheral nerves: linkage with the "mushrooming" effect. Cell Tissue Res. 2004;316:115-121.
40. Tillett R, Afoke A, Hall S, et al. Investigating mechanical behaviour at a core-sheath interface in peripheral nerve. J Peripher Nerv Syst. 2004;9:255-262.
41. Georgeu G, Walbeehm E, Tillett R, et al. Investigating the mechanical shear-plane between core and sheath elements of peripheral nerves. Cell Tissue Res. 2005;320:229-234.
42. Borschel G, Kia K, Kuzon W, Dennis R. Mechanical properties of acellular peripheral nerve. J Surg Res. 2003;114:133-139.
43. Phillips J, Smit X, De Zoysa N, et al. Peripheral nerves in the rat exhibit localized heterogeneity of tensile properties during limb movement. J Physiol. 2004;557:879-887.
44. Wall E, Kwan M, Rydevik B, et al. Stress relaxation of a peripheral nerve. J Hand Surg Am. 1991;16:859-863.
45. Wall E, Massie J, Kwan M, et al. Experimental stretch neuropathy; changes in nerve conduction under tension. J Bone Joint Surg Br. 1992;74:126-129.
46. Grewal R, Xu J, Sotereanos D, Woo S-Y. Biomechanical properties of peripheral nerves. Hand Clin. 1996;12:195-204.
47. Orf G, Wust R. Mechanical loading of peripheral nerves during remobilisation of the affected member after end-to-end anastomosis. Acta Neurochir (Wien). 1979;49:103-121.
48. Dyck P, Lais A, Giannini C, Engelstad J. Structural alterations of nerve during cuff compression. Proc Natl Acad Sci U S A. 1990;87:9828-9832.
49. Hodgson A. Avoiding tourniquet-induced neuropathy through cuff design. Biomed Instrum Technol. 1993;27:401-407.
50. Lundborg G. Nerve Injury and Repair. New York, NY: Churchill Livingstone; 1988:64-101.
51. Millesi H. The nerve gap: theory and clinical practice. Hand Clin. 1986;2:651-663.
52. Suliman I, Lindgren J, Gillberg P-G, et al. Effect of immobilization on skeletal muscle nicotinic cholinergic receptors in the rat. Neuro-Report. 1997;8:2821-2824.
53. Marcianak M, Morphometric ultrastructural evaluation of the axonal endings in the neuromuscular junctions of pigeons after long lasting limitation of movement. Exp Pathol. 1983;23:27-34.
54. Baranski S, Marcianak M. Stereological ultrastructural analysis of the axonal endings in the neuromuscular junction of rats after a flight on Biosputnik 782. Aviat Space Environ Med. 1979;50:14-17.
55. Pachter B, Eberstein A. The effect of limb immobilization and stretch on the fine structure of the neuromuscular junction in rat muscle. Exp Neurol. 1986;92:13-19.
56. Malathi S, Batmanabane M. Effects of varying periods of immobilization of a limb on the morphology of a peripheral nerve. Acta Morphol Neerl Scand. 1983;21:185-198.
57. Malathi S, Batmanabane M. Effects of immobilization of a limb on the maturation of a peripheral nerve in kittens. Acta Anat. 1988;132:191-196.
58. Eisen A, Bellavance A, Carpenter S, Karpati G. The effects of muscle hyper- and hypoactivity upon fiber diameters of intact and regenerating nerves. J Neurol Sci. 1973;20:457-469.
59. Appenzeller O, Ogin G, Palmer G. Fiber size spectra and cyclic AMP content of sciatic nerves: effect of muscle hypoactivity and hyperactivity. Exp Neurol 1976;50:595-604.
60. Balster S, Jull G. Upper trapezius muscle activity during the brachial plexus tension test in asymptomatic subjects. Man Ther. 1997;2:144-149.
61. Coppieters M, VanDeVelde M, Stappaerts K. Positioning in anesthesiology: toward a better understanding of stretch-induced perioperative neuropathies. Anesthesiology. 2002;97:75-81.
62. Kalichman M, Myers R. Transperineurial vessel constriction in an edematous neuropathy. J Neuropathol Exp Neurol. 1991;50:408-418.
63. Tanoue M, Yamaga M, Ide J, Takagi K. Acute stretching of peripheral nerves inhibits retrograde axonal transport. J Hand Surg Br. 1996;21:358-363.
64. Clark W, Trumble T, Swiontkowski M, Tencer A. Nerve tension and blood flow in a rat model of immediate and delayed repairs. J Hand Surg Am. 1992;17:677-687.
65. Iida H, Schmeichel A, Wang Y, et al. Schwann cell is a target in ischemia-reperfusion injury to peripheral nerve. Muscle Nerve. 2004;30:761-766.
66. Eltzschig H, Collard C. Vascular ischaemia and reperfusion injury. Br Med Bull. 2004;70:71-86.
67. Ogata K, Naito M. Blood flow of peripheral nerve effects of dissection, stretching and compression. J Hand Surg Br. 1986;11:10-14.
68. Jou I, Lai K, Shen C, Yamano Y. Changes in conduction, blood flow, histology, and neurological status following acute nerve-stretch injury induced by femoral lengthening. J Orthop Res. 2000;18:149-155.
69. Skoulis T, Vekris M, Terzis J. Effect of distraction osteogenesis on the peripheral nerve: experimental study in the rat. J Reconstr Microsurg. 1998;14:565-574.
70. Galardi G, Comi G, Lozza L, et al. Peripheral nerve damage during limb lengthening: neurophysiology in five cases of bilateral tibial lengthening. J Bone Joint Surg Br. 1990;72:121-124.
71. Shibukawa M, Shirai Y. Experimental study on slow-speed elongation injury of the peripheral nerve: electrophysiological and histological changes. Orthop Sci. 2001;6:262-268.
72. Hara Y, Shiga T, Abe I, et al. P0 mRNA expression increases during gradual nerve elongation in adult rats. Exp Neurol. 2003;184:428-435.
73. Abe I, Ochiai N, Ichimura H, et al. Internodes can nearly double in length with gradual elongation of the adult rat sciatic nerve. J Orthop Res. 2004;22:571-577.
74. Hu J, Zou S, Tang Z, et al. Response of Schwann cells in the inferior alveolar nerve to distraction osteogenesis: an ultrastructural and immunohistochemical study. Int J Oral Maxillofac Surg. 2003;32:318-324.
75. Rydevik L, Lundborg G, Bagge U. Effects of graded compression on intraneural blood flow: an in vivo study on rabbit tibial nerve. J Hand Surg Am. 1981;6:3-12.
76. Gelberman R, Hergenroeder P, Hargens A, et al. The carpal tunnel syndrome: a study of carpal canal pressure. J Bone Joint Surg Am. 1981;63:380-383.
77. Szabo R, Chidgey L. Stress carpal tunnel pressures in patients with carpal tunnel syndrome and normal patients. J Hand Surg Am. 1989;14:624-627.
78. Rojviroj S, Sirichativapee W, Kowsuwon W, et al. Pressure in the carpal tunnel: a comparison between patients with carpal tunnel syndrome and normal subjects. J Bone Joint Surg Br. 1990;72:516-518.
79. Keir P, Bach J, Rempel D. Effects of computer mouse design and task on carpal tunnel pressure. Ergonomics. 1999;42:1350-1360.
80. Keir P, Bach J, Rempel D. Effects of finger posture on carpal tunnel pressure during wrist motion. J Hand Surg Am. 1998;23:1004-1009.
81. Bora F, Richardson S, Black J. The biomechanical responses to tension in a peripheral nerve. J Hand Surg Am. 1980;5:21-25.
82. Szabo R, Gelbermann R, Williamson R, Hargens A. Effects of increased systemic blood pressure on the tissue fluid pressure threshold of peripheral nerve. J Orthop Res. 1983;1:172-178.
83. Powell H, Myers R. Pathology of experimental nerve compression. Lab Invest. 1986;55:91-100.
84. Lundborg G, Myers R, Powell H. Nerve compression injury and increased endoneurial fluid pressure: a "miniature compartment syndrome." J Neurol Neurosurg Psychiatry. 1983;46:1119-1124.
85. Dahlin L, McLean W. Effects of graded experimental compression on slow and fast axonal transport in rabbit vagus nerve. J Neurol Sci. 1986;72:19-30.
86. Dahlin L, Sjostrand J, McLean W. Graded inhibition of retrograde axonal transport by compression of rabbit vagus nerve. J Neurol Sci. 1986;76:221-230.
87. Rydevik B, McLean W, Sjostrand J, Lundborg G. Blockage of axonal transport induced by acute, graded compression of the rabbit vagus nerve. J Neurol Neurosurg Psychiatry. 1980;43:690-698.
88. Bennett G, Xie Y-K. A peripheral mononeuropathy in rat that produces disorders of pain sensation like those seen in man. Pain 1988;33:87-107.
89. Mackinnon S, Dellon A, Hudson A, Hunter D. Chronic nerve compression: an experimental model in the rat. Ann Plast Surg. 1984;13:112-120.
90. O'Brien J, Mackinnon S, MacLean A, et al. A model of chronic nerve compression in the rat. Ann Plast Surg. 1987;19:430-435.
91. Diao E, Shao F, Liebenberg E, et al. Carpal tunnel pressure alters median nerve function in a dose-dependent manner: a rabbit model for carpal tunnel syndrome. J Orthop Res. 2005;23:218-223.
92. Rempel D, Diao E. Entrapment neuropathies: pathophysiology and pathogenesis. J Electromyogr Kinesiol. 2004;14:71-75.
93. Cook A, Szabo R, Birkholz S, King E. Early mobilization following carpal tunnel release. J Hand Surg Br. 1995;20:228-230.
94. Tal-Akabi A, Rushton A. An investigation to compare the effectiveness of carpal bone mobilisation and neurodynamic mobilisation as methods of treatment for carpal tunnel syndrome. Man Ther. 2000;5:214-222.
95. Akalin E, El O, Peker O, et al. Treatment of carpal tunnel syndrome with nerve and tendon gliding exercises. Am J Phys Med Rehabil. 2002;81:108-113.
96. Akesson I, Lundborg G, Horstmann V, Skerfving S. Neuropathy in female dental personnel exposed to high frequency vibrations. Occup Environ Med. 1995;52:116-123.
97. Necking L, Friden J, Lundborg G. Reduced muscle strength in abduction of the index finger: an important clinical sign in hand arm vibration syndrome. Scand J Plast Reconstruct Surg Hand Surg. 2003;37:365-370.
98. Necking L, Lundborg G, Lundstrom R, et al. Hand muscle pathology after long-term vibration exposure. J Hand Surg Br. 2004;29:431-437.
99. Stromberg T, Dahlin L, Brun A, Lundborg G. Structural nerve changes at wrist level in workers exposed to vibration. Occup Environ Med. 1997;54:307-311.
100. Lundborg G, Dahlin L, Hansson H, et al. Vibration exposure and peripheral nerve fiber damage. J Hand Surg Am. 1990;15:346-351.
101. Chang K, Ho S, Yu H. Vibration induced neurophysiological and electron microscopical changes in rat peripheral nerves. Occup Environ Med. 1994;51:130-135.
102. Barr A, Barbe M. Pathophysiological tissue changes associated with repetitive movement: a review of the evidence. Phys Ther. 2002;82:173-187.
103. Clark B, Barr A, Safadi F, et al. Median nerve trauma in a rat model of work-related musculoskeletal disorder. J Neurotrauma. 2003;20:681-695.