- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02941133
Comparison of Neural Mobilization Techniques to Standard Care Treatment in Patients With Lumbar Radiculitis
Effectiveness of Neural Mobilization Techniques Compared to Standard Care Treatment in Patients With Lumbar Radiculitis: A Randomized Clinical Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background:
Radicular pain has been regarded as a distinct pain entity as its pathophysiology differs from that of somatic referred pain and nociceptive pain. Radicular lumbar pain describes sensitized nerve roots of the lumbar spine or peripheral nerve trunks that are capable of producing pain (usually below the knee) and/or other symptoms in the absence of true nerve tissue damage. This type of pain is evoked by ectopic discharges stemming from lumbar dorsal roots or their ganglions. The most common causes for this type of pain is the inflammatory environment that is produced by substances contained in the herniated material of injured lumbar intervertebral discs.
It has been suggested that patients presenting with functional (e.g. mechanosensitivity) but not structural nerve root problems, can be identified through screening and further classified as a discrete group of patients that benefit from specific neural mobilization techniques.
Neural mobilization techniques have gained considerable amount of attention amongst therapists and researchers for the assessment and treatment of painful conditions that occasionally involve a neural element in their pathophysiology such as lumbar radicular pain. Studies exploring the effect of neural mobilization techniques on patients with lumbar radicular pain have generally shown good results but they are lacking in adequate sample size and methodological quality.
The aim of this study is to compare the effectiveness of neural mobilization techniques to standard care physiotherapy treatment (ultrasound, general exercises, massage therapy, transcutaneous electrical nerve stimulation) in patients with lumbar radiculitis.
Participants:
Patients with low back pain that radiates to the lower limb.
Patients that satisfy the inclusion criteria will be screened and classified by another researcher into the distinct group of lumbar radiculitis. Another researcher will take baseline measurements and all patients of this sub-group will be randomly assigned to receive either neural mobilization or standard care physiotherapy treatment. Both groups will receive a total of 10 treatments twice per week for 5 weeks. Patients will be assessed using specific outcome measures prior to treatment (baseline), at 5 weeks (post treatment) and 6 months after treatment.
Statistical analysis:
Data will be analysed with the Statistical Package for the Social Sciences (SPSS), version 22. Intension to treat analysis will be applied. A two-way mixed-model analysis of variance will be used for outcome measures, with treatment groups (neural mobilization or standard care treatment) as the between-subject variable and time (baseline, 1 month follow up, six months follow up) as the within-subject variable. Comparison of baseline demographic characteristics will be analysed using the t-tests for continuous variables and the chi square tests for categorical variables.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Michalis Efstathiou, MSc
- Phone Number: +35799931840
- Email: efstathiou.m@unic.ac.cy
Study Contact Backup
- Name: Manos Stefanakis, PhD
- Phone Number: +35796418779
- Email: stefanakis.m@unic.ac.cy
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with low back pain and pain that radiates in the lower limb
- Duration of symptoms > 6 weeks
- Patients willing to be reassessed after 6 months
- Patients willing to give written informed consent
Exclusion Criteria:
- History of spinal surgery
- History of surgery or injury in the lower limbs in the past 6 months
- Signs and symptoms of central nervous system involvement
- Nerve root blocks for the past 6 weeks
- History of diabetes
- History of polyneuropathies
- History of vascular pathologies in the lower limbs
- History of systemic pathologies
- History of inflammatory arthropathies
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Neural Mobilization Group
Patients in this group will be treated with neural mobilization techniques.
|
Neural mobilization techniques aimed at the lumbar root that is affected
|
Experimental: Standard Care Group
Patients in this group will be treated with standard care (ultrasound, exercise, TENS, massage)
|
Ultrasound - Transcutaneous electrical nerve stimulation (TENS) - Massage therapy - Strengthening exercises
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Visual Analogue Scale (VAS) - Measure assessing change
Time Frame: Change from baseline after 5 weeks and at 6 months
|
The VAS is a 100-point pain assessment scale ranging from 0 (no pain) to 100 (worst pain possible).
|
Change from baseline after 5 weeks and at 6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Roland Morris Disability Questionnaire (RMDQ) - Measure assessing change
Time Frame: Change from baseline after 5 weeks and at 6 months
|
The questioner measures the level of patients' disability.
|
Change from baseline after 5 weeks and at 6 months
|
Fear Avoidance and Beliefs Questionnaire (FABQ) - Measure assessing change
Time Frame: Change from baseline after 5 weeks and at 6 months
|
The questioner evaluates fear-avoidance beliefs of patients with low back pain in the clinical setting.
|
Change from baseline after 5 weeks and at 6 months
|
Handheld dynamometer - Measure assessing change
Time Frame: Change from baseline after 5 weeks and at 6 months
|
Changes in Muscle Strength assessed with the handheld dynamometer
|
Change from baseline after 5 weeks and at 6 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Michalis Efstathiou, MSc, University of Nicosia
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- MISS13
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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