The Upper Limb Neurodynamic Test 1: Intra- and Intertester Reliability and the Effect of Several Repetitions on Pain and Resistance

ObjectiveThe aim of this study is to measure the intra- and intertester reliability of the Upper Limb Neurodynamic Test 1 in asymptomatic subjects with respect to onset of pain, submaximal pain (SP), first resistance (R1), and second resistance, and determine the effect of several repetitions of the test.MethodsThree physiotherapists evaluated the dominant upper arm of 36 asymptomatic adult subjects 5 times with an electrogoniometer.ResultsIntratester reliability for R1 was good with an intraclass correlation coefficient (ICC 3,1) ranging from 0.69 to 0.91. Intertester reliability was fair for R1 (0.48, standard error [SE] = 0.14), second resistance (0.62, SE = 0.011), and SP (0.64, SE = 0.09), but good for onset of pain (0.72, SE = 0.011). The ICCs on 5 repetitions for each observer were higher, ranging from 0.51 (R1, SE = 0.066) to 0.76 (SP, SE = 0.049). Using the data from the 2 more expert physiotherapists, almost all ICCs were in the good range. The effect of 5 repetitions was a statistically significant progressive improvement of range on all parameters from the first to the final repetition.ConclusionsOur results regarding the reliability are in line with other studies on the reliability of manual therapy tests. Moreover, the cumulative effect of repetition suggests that the Upper Limb Neurodynamic Test 1 may warrant investigation as a treatment technique.