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Measurement of longitudinal tibial nerve excursion during ankle joint dorsiflexion: an in-vivo investigation with ultrasound imaging


A key mechanical function of peripheral nerves is their ability to slide in relation to the surrounding tissues. This function is of paramount importance to maintain ideal neural function [1]. Advances in ultrasound imaging and the development of specific software (cross-correlation analysis) have made it possible to analyse real-time ultrasound images, allowing for quantification of in-vivo peripheral nerve movement [2]. Cross-correlation analysis has been utilised in numerous upper extremity in-vivo neural investigations [35]. No study has investigated in-vivo longitudinal nerve excursion at the ankle joint. The aims of this study were to quantify the degree of longitudinal tibial nerve excursion as the ankle moved from dorsiflexion to plantarflexion and assess the between session intra-rater reliability of the ultrasound imaging technique.

Materials and methods

A sample of sixteen participants (10 male, 6 female; mean [SD] age 34.7 [9.3] years old) were recruited. A three second video loop of the tibial nerve was captured by ultrasound imaging as the ankle moved from 20° plantarflexion to 10° dorsiflexion. The tibial nerve was imaged on two occasions with a 5 minute interval between measurement sessions. Foot and ankle position was standardised on a measurement platform. Video loops were analysed to determine the degree of longitudinal nerve excursion. Intraclass correlation coefficients (ICC), with 95% confidence intervals (CI), standard error of the measurement (SEM) and the smallest real difference (SRD) were calculated as an indication of reliability and measurement error.


Results demonstrated mean [SD] longitudinal excursion of 3.01 [0.97] mm. The between session intra-rater reliability was excellent (ICC=0.93; 95% CI, 0.70-0.96), with SEM, 0.26mm and a mean SRD of 0.75mm.


Ultrasound imaging in conjunction with cross correlation analysis presents a reliable technique to quantify in-vivo tibial nerve movement during ankle joint dorsiflexion.


  1. Shacklock M: Clinical Neurodynamics: A new system of musculoskeletal treatment. 2005, Edingburgh: Elsevier

    Google Scholar 

  2. Dilley A, et al: The use of cross-sectional analysis between high-frequency ultrasound images to measure longitudinal median nerve movement. Ultrasound Med Biol. 2001, 27: 1211-1218. 10.1016/S0301-5629(01)00413-6.

    Article  CAS  PubMed  Google Scholar 

  3. Erel E, et al: Longitudinal sliding of the median nerve in patients with carpal tunnel syndrome. J Hand Surg Br. 2003, 28: 439-443.

    Article  CAS  PubMed  Google Scholar 

  4. Dilley A, et al: Quantitative in vivo studies of median nerve sliding in response to wrist, elbow, shoulder and neck movements. Clin Biomech (Bristol, Avon). 2003, 18: 899-907. 10.1016/S0268-0033(03)00176-1.

    Article  Google Scholar 

  5. Dilley A, Summerhayes C, Lynn B: An in vivo investigation of ulnar nerve sliding during upper limb movements. Clin Biomech (Bristol, Avon). 2007, 22: 774-779. 10.1016/j.clinbiomech.2007.04.004.

    Article  Google Scholar 

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Correspondence to Matthew Carroll.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Carroll, M., Yau, J., Rome, K. et al. Measurement of longitudinal tibial nerve excursion during ankle joint dorsiflexion: an in-vivo investigation with ultrasound imaging. J Foot Ankle Res 5 (Suppl 1), O37 (2012).

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