Effects of Neurodynamic Mobilization and Stretching Exercises for Chronic Discogenic Sciatica (NDM)

Effects of Slider, Tensioner Neurodynamic Mobilization Techniques and Stretching Exercises in Treatment of Chronic Discogenic Sciatica: A Comparative Study

This study compares between neurodynamic mobilization and stretching exercises in treatment of chronic dicogenic sciatica

Study Overview

• Status: Completed
• Conditions: Physical Therapy
• Intervention / Treatment: Other: Slider, tensioner neurodynamic mobilization techniques and stretching exercises of back, hamstrings and gastrocnemius

Detailed Description

This study was conducted at the outpatient clinics, faculty of physical Therapy, Kafrelsheikh University to compare between the effects of slider, tensioner neurodynamic mobilization techniques and stretching exercises on pain, Range of motion (ROM) and functional disability for patients with chronic discogenic sciatica.

Design of the study:

A pre-test post-test three-armed comparative study design was used for comparison between the effects of slider, tensioner neurodynamic mobilization techniques and stretching exercises for patients with chronic discogenic sciatica.

Selection of patients:

Sample size:

Using G-power software program and regarding F test study , alpha level of 0.05, confidence interval 95% and effect size of 0.25 (to detect small effects ), three groups and 6 dependent variables, the total sample size will be 36 patient (twelve in each group).

To reach the specific sample size, forty-three patients were screened regarding the inclusion/exclusion criteria. Thirty-six patient with unilateral chronic discogenic sciatica from both sexes (….male and … female) were recruited from the outpatient clinics, faculty of physical Therapy, Kafrelsheikh University. Their age ranged between 21-50 years.

They were randomly allocated by simple random method; to avoid selection bias, patients were asked to choose a card of three wrapped cards representing the three treatment groups:

Group (A): received Slider technique only. Group (B): received Tensioner technique only. Group (C): received Stretching exercises of back extensors, hamstrings and gastrocnemius muscles only.

• Study Type: Interventional
• Enrollment (Actual): 36
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Haytham Morsi, B.Sc.; Phone Number: +201013657738; Email: 10722019485962@pg.cu.edu.eg

Study Locations

• Egypt
  • Giza, Egypt
    • Haytham Ibrahim Morsi

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years to 50 years (Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Patients diagnosed by magnetic resonance imaging (MRI) confirming disc lesion.
2. Radicular pain for at least twelve weeks up to one year with no acute episodes for the last four weeks.
3. Positive slump test, with reproduction of neurological symptoms.
4. Ages of 21-50 years of both sexes.
5. Patients with functional disabilities e.g. during lifting or walking

Exclusion Criteria:

1. Patients with sciatica due to other pathologies e.g. lumbar canal stenosis or piriformis syndrome.
2. Patients after any spinal surgery e.g. unilateral hemilaminectomy or microdiscectomy
3. Negative slump test.
4. Progressive neurological symptoms e.g. hyperirritable and unstable symptoms.
5. History of vertebral fracture or trauma.
6. Systemic disorder e.g. diabetes mellitus.
7. Pregnant women.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Slider neurodynamic mobilization technique only; a neurodynamic mobilization technique of the sciatic nerve with stretch on one nerve end and slackness on the other end.	Other: Slider, tensioner neurodynamic mobilization techniques and stretching exercises of back, hamstrings and gastrocnemius; neurodynamic mobilization techniques of sciatic nerve and stretching exercises of back extensors, hamstrings and lower limbs for patients with chronic discogenic sciatica.; Other Names: sliders, tensioners and stretching exercise
Active Comparator: Tensioner neurodynamic mobilization technique only; a neurodynamic mobilization technique of the sciatic nerve with stretch of both nerve ends.	Other: Slider, tensioner neurodynamic mobilization techniques and stretching exercises of back, hamstrings and gastrocnemius; neurodynamic mobilization techniques of sciatic nerve and stretching exercises of back extensors, hamstrings and lower limbs for patients with chronic discogenic sciatica.; Other Names: sliders, tensioners and stretching exercise
Active Comparator: Stretching exercises of back extensors, hamstrings and gastrocnemius muscles; Stretching exercises of back extensors, hamstrings and gastrocnemius to relief the pressure on the nerve.	Other: Slider, tensioner neurodynamic mobilization techniques and stretching exercises of back, hamstrings and gastrocnemius; neurodynamic mobilization techniques of sciatic nerve and stretching exercises of back extensors, hamstrings and lower limbs for patients with chronic discogenic sciatica.; Other Names: sliders, tensioners and stretching exercise

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in pain intensity measurements using visual analogue scale	A scale form 0 to 10 points, a less score means improvement.	Before treatment and after 2 weeks of treatment.
Change in hip flexion range of motion measurement using universal goniometer.	the therapist measures it for patients, an increasing value means improvement.	Before treatment and after 2 weeks of treatment.
Change in knee extension range of motion measurement using universal goniometer.	the therapist measures it for patients, an increasing value means improvement.	Before treatment and after 2 weeks of treatment.
Change in ankle dorsiflexion range of motion measurement using universal goniometer.	the therapist measures it for patients, an increasing value means improvement.	Before treatment and after 2 weeks of treatment.
Change in lumbar flexion range of motion measurement using universal goniometer.	the therapist measures it for patients, an increasing value means improvement.	Before treatment and after 2 weeks of treatment.
Change in functional disability measurement using the oswestry disability index.	An index indicating disability level, a less score indicates improvement.	Before treatment and after 2 weeks of treatment.

Collaborators and Investigators

• Sponsor: Cairo University
• Collaborators: Kafrelsheikh University
• Investigators: Principal Investigator: Bassem El-nahass, Professor, Professor of Orthopaedic Physical Therapy

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2020
• Primary Completion (Actual): March 31, 2021
• Study Completion (Actual): March 31, 2021

Study Registration Dates

• First Submitted: January 31, 2021
• First Submitted That Met QC Criteria: February 6, 2021
• First Posted (Actual): February 10, 2021

Study Record Updates

• Last Update Posted (Actual): April 28, 2023
• Last Update Submitted That Met QC Criteria: April 27, 2023
• Last Verified: April 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nervous System Diseases; Pain; Neurologic Manifestations; Neuromuscular Diseases; Sciatic Neuropathy; Mononeuropathies; Peripheral Nervous System Diseases; Neuralgia; Sciatica
• Other Study ID Numbers: P.T.8/8/93

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: No availability of participant data

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No