Background and purpose: Neurodynamics is the concept based on a close interaction of mechanics and physiology of the nervous system which is to be considered while assessing and treating patients via nervous system mobilization and manual therapy. Neurodynamic assessment includes neurodynamic testing and nerve trunk palpation. Diabetes was shown to affect neural microcirculatory networks and neural connective tissue sheaths which may affect neurodynamic properties. The purpose of this study was to compare the neurodynamic findings in diabetic subjects, painless neuropathy and painful neuropathy with normal asymptomatic subjects.,Materials and methods: The study was an observer-blinded cross-sectional study on 164 subjects (98 male, 66 female) of mean age ± years. Type-2 diabetes mellitus was diagnosed with fasting blood glucose levels and glycosylated haemoglobin. Peripheral neuropathy with VPT > 25 volts in bilateral feet; neuropathic pain identified on neuropathic pain questionnaire (NPQ) with NPQ score d” 0 implied painless and > 0 implied painful neuropathy. The tester administered neurodynamic testing and nerve trunk palpation to bilateral lower limb nerves. The outcomes of pain, resistance and range of motion for neurodynamic test and presence/ absence of mechanical allodynia on nerve trunk palpation were documented. Prevalence of neurodynamics among the study population was assessed for sciatic, tibial and common peroneal nerves., Data analysis and results: Prevalence data was analyzed descriptively using percentiles and compared using Chi-square test. One-way analysis of variance was used for comparing neurodynamic test findings across the nerve-groups at 95% confidence interval using SPSS 12.0.1 for Windows. Post-hoc analysis was done using Bonferonni test. Secondary analysis was done using paired t-test for to evaluate interaction of range of motion with study group. The PDPN group had the greatest abnormalities in neurodynamic examination findings compared to diabetic group. The painless neuropathy group was similar to normal group in their findings. Sciatic and tibial nerve was involved together in neurodynamic testing and all three nerves were sensitive to nerve trunk palpation in PDPN group.,Conclusion:Abnormal neurodynamic findings in PDPN patients were demonstrated in terms of positive sciatic and tibial neurodynamic tests and by nerve trunk palpation for all three nerves. PDPN group had greater abnormalities in neurodynamics than diabetic subjects studied.

Key words: Neurodynamic testing, mechanosensitivity, diabetic neuropathy, manual therapy, nerve trunk palpation.