The Impact of High Frequency Electrical Nerve Stimulation and Chiropractic Care on Sciatic Axonal Lesion Presenting as Painful Leg: Case Report

June 20, 2023 updated by: Mshari Saleh Alghadier, Prince Sattam Bin Abdulaziz University

To present an evidence-based case report on the prognosis of a pediatric patient with right sciatica and painful leg. A 5-year-old girl with limping gait, presented with right-sided buttock and lower extremity pain and numbness. There has been a history of trauma prior to this 18-month ago. Following clinical examination, she was found to have numbness along the entire length of her right leg, in addition to a little sensory disturbance, accompanied by weakening in that leg. There was a generalized loss in sensation to pinprick as well as light touch, but it was most noticeable above the right knee joint. The remaining of the clinical exam was normal.

High frequency electrical stimulation was done for thirty minutes per day for five days a week for four consecutive weeks. The stimulator provides a biphasic current of 100 Hz frequency. The pulse duration was 200 msec with an (on-off). Stimulus mode (20sec stimulation, 20 sec pause). The maximal stimulation amplitude was 40 - 60 mA.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

A 5-year-old girl with limping gait, presented with right-sided buttock and lower extremity pain and numbness. There was a history of trauma preceding this eighteen months ago. There was diffuse decreased sensation to pinprick and light touch but mainly from above the right knee joint. The rest of the clinical examination was normal. The patient attended 20 sessions, which were structured to include High-frequency transcutaneous neuromuscular electrical nerve stimulation (TENS), chiropractic care, strengthening exercise for hamstring and back muscle and gait training (figure 1). Electrical stimulation was performed for 30 min /day for five days a week for four consecutive weeks, 100 Hz frequency with pulse duration 200 m sec with an (on-off) (20 sec stimulation, 20 sec pause) and maximum amplitude 40 - 60 mA. Two electrodes were placed on the back at the level of L5, S1 lumber spine and the other two electrodes were placed along the course of sciatic nerve on the back of the thigh. Chiropractic treatment sessions (manual manipulation refers to a high-velocity, short lever arm thrust that is applied to abnormal vertebra with the goal of improving functionality, reducing nerve irritability and restoring range of motion in the back) were scheduled for one month with frequency 5 sessions per week. strengthening program was three sets, ten repetitions and rest period of 1-2 minutes for low intensity or low repetition activity started by 2-3 days a week, then increase to 3-5 days a week as the strength progresses, amount of resistance 40%-60% of one-repetition maximum (1 RM). Mirror imaging and verbal promoting, Balance training and coordination to encourage normal gait.

EMG examination using concentric needle electrodes was carried bilaterally for the vastus medialis, tibialis anterior, extensor digitorum brevis and abductor halluces muscles and the right biceps femoris muscle. Motor conduction studies were carried out for both common peroneal, tibial and right main trunk of the right sciatic nerve.

Study Type

Observational

Enrollment (Actual)

1

Contacts and Locations

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

Study Locations

  • Egypt
    • Qena
      • Qinā, Qena, Egypt, 83523
        • Faculty of physical therapy

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

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Children with sciatica nerve pain

Description

Inclusion Criteria:

  • Sciatica nerve pain
  • Able to attend 20 sessions
  • Children age 5-10 years

Exclusion Criteria:

  • Chronic pain
  • Pain in the spine other than Sciatica

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Intervention
High frequency electrical stimulation was done for thirty minutes per day for five days a week for four consecutive weeks. The stimulator provides a biphasic current of 100 Hz frequency. The pulse duration was 200 msec with an (on-off). Stimulus mode (20sec stimulation, 20 sec pause). The maximal stimulation amplitude was 40 - 60 mA
Other: TENS and Exercise
High frequency electrical stimulation was done for thirty minutes per day for five days a week for four consecutive weeks. The stimulator provides a biphasic current of 100 Hz frequency. The pulse duration was 200 msec with an (on-off). Stimulus mode (20sec stimulation, 20 sec pause). The maximal stimulation amplitude was 40 - 60 mA

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Nerve conduction velocity
Time Frame: 4 weeks
Motor conduction studies were carried out for both common peroneal, tibial and right main trunk of the right sciatic nerve.
4 weeks

Collaborators and Investigators

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

Sponsor

Prince Sattam Bin Abdulaziz University

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 (Actual)

February 2, 2023

Primary Completion (Actual)

May 1, 2023

Study Completion (Actual)

May 1, 2023

Study Registration Dates

First Submitted

June 9, 2023

First Submitted That Met QC Criteria

June 20, 2023

First Posted (Actual)

June 28, 2023

Study Record Updates

Last Update Posted (Actual)

June 28, 2023

Last Update Submitted That Met QC Criteria

June 20, 2023

Last Verified

June 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • P.T-IMG-02/2023/507

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Only IPD used in the publication will be shared.

IPD Sharing Time Frame

01/07/2023 - 01/07/2024

IPD Sharing Access Criteria

Team researchers

IPD Sharing Supporting Information Type

  • CSR

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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