Effects of Spinal Mobilization With Leg Movement With and Without Neural Flossing Technique in Lumbar Radiculopathy

June 8, 2026 updated by: Riphah International University

Effects of Spinal Mobilization With Leg Movement With and Without Neural Flossing Technique on Pain, Disability, and Range of Motion in Patients With Lumbar Radiculopathy

Lumbar radiculopathy is a spinal condition caused by compression or irritation of the lumbar nerve roots, leading to radiating leg pain, sensory changes, and functional disability. It commonly affects middle-aged and older adults, impairing daily activities and quality of life. Conservative treatments include medication, physiotherapy, and exercise. Spinal Mobilization with Leg Movement (SMWLM), a Mulligan technique, uses passive vertebral mobilization with active leg motion to reduce nerve compression and improve mobility. Neural flossing, or neurodynamic mobilization, enhances nerve mobility by promoting gliding of nerve roots, especially in cases of restricted neural movement. This study aims to evaluate the effects of spinal mobilization with leg movement (SMWLM) with and without neural flossing technique on pain, disability, and range of motion in patients with lumbar radiculopathy.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This single-blinded randomized clinical trial will be conducted at Noor Al-Shifa Hospital, Lahore, over 10 months following ethical approval. A total of 36 patients (18 in each group) with lumbar radiculopathy will be recruited by using non-probability convenience sampling. Group A will receive spinal mobilization with leg movement (SMWLM) with neural flossing technique, while Group B will receive spinal mobilization with leg movement (SMWLM) only. Each group will undergo treatment 3 times per week for 6 weeks, with each session lasting 45 minutes. Pre- and post-intervention assessments will include pain (NPRS), SLR range of motion (Goniometer), and disability (Modified Oswestry Disability Index). Data will be analyzed using SPSS version 26

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
36

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54920
        • Physio house (Comprehensive Rehab Center)
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • • Patients aged between 30-50 years (9)

    • Both male and female genders
    • Patient should have lower back pain radiating to one side with numbness, tingling, and muscle weakness (12)
    • Positive Lasegue & slump test

Exclusion Criteria:

  • Any fracture or other injury

    • Any systemic illness
    • Any inflammatory disease (Rheumatoid arthritis, gout)
    • Disc herniation
    • Piriformis syndrome
    • Lumbar instability
    • Scoliosis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: SMWLM along with neural flossing technique
Spinal Mobilization with Leg Movement (SMWLM) and Neural Flossing are highly effective, conservative physical therapy approaches for managing lumbar radiculopathy (sciatica). They aim to reduce nerve root compression, disperse neural edema, and restore the healthy gliding of nerves within their surrounding tissues
Other: SMWLM along with Neural flossing technique
The participant will be positioned in side-lying with limb where the pain radiated to on top. Therapist 1 will stand at the participant's ventral side and apply transverse glide with the thumb on the involved lumbar spinous process. Therapist 2 will then abduct the affected leg by 10° and take the limb gently into hip flexion with knee extended, while the glide will be sustained continuously by therapist 1. The entire motion during mobilization will be maintained pain-free. The participant will be positioned in side-lying with limb where the pain radiated to on top. Therapist 1 will stand at the participant's ventral side and apply transverse glide with the thumb on the involved lumbar spinous process. Therapist 2 will then abduct the affected leg by 10° and take the limb gently into hip flexion with knee extended, while the glide will be sustained continuously by therapist 1. The entire motion during mobilization will be maintained pain-free.
Active Comparator: SMWLM without neural flossing technique
Spinal Mobilization with Leg Movement (SMWLM) is a manual therapy technique developed by Brian Mulligan to treat lumbar radiculopathy. It combines sustained gliding pressure on the lumbar spine with passive or active straight leg raises to alleviate nerve compression, reduce pain, and restore mobility
Other: SMWLM without Neural flossing technique
The participant will be positioned in side-lying with limb where the pain radiated to on top. Therapist 1 will stand at the participant's ventral side and apply transverse glide with the thumb on the involved lumbar spinous process. Therapist 2 will then abduct the affected leg by 10° and take the limb gently into hip flexion with knee extended, while the glide will be sustained continuously by therapist 1. The entire motion during mobilization will be maintained pain-free. The procedure will be repeated three times as per Mulligans rule of 3, post which the SLR test and NPRS will be re-measured

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Numeric Pain Rating Scale for Pain
Time Frame: upto 4 weeks
It is a widely used subjective measure for assessing pain intensity, where patients rate their pain on a scale from 0 (no pain) to 10 (worst imaginable pain). It has high test-retest reliability (ICC = 0.92) and strong construct validity for acute and chronic musculoskeletal conditions
upto 4 weeks
Goniometer for ROM
Time Frame: Upto 4 weeks
It is a clinical instrument used to measure joint range of motion in degrees, commonly applied in musculoskeletal assessments. It demonstrates excellent intra-rater (ICC = 0.95) and inter-rater reliability (ICC = 0.89), with strong validity when compared with digital motion analysis tools
Upto 4 weeks
Modfied Oswestry Disability Index for disability
Time Frame: Upto 4 weeks
It is a self-reported questionnaire used to assess disability due to low back pain, covering aspects such as pain, mobility, and daily activities. It is a highly valid tool (construct validity r = 0.75) with excellent reliability (Cronbach's alpha = 0.90, ICC = 0.91), making it one of the most commonly used functional outcome measures in spine-related research
Upto 4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Riphah International University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Rahat Afzal, MS-OMPT, Governement Teaching Hospital Shahdara Lahore.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
May 30, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
July 30, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
August 30, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 8, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 12, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 12, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 8, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • REC/RCR&AHS/25/0124 Ruhma

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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