Modified Sciatic Nerve Mobility Exercises on Hamstring Tightness

Effectiveness of Modified Sciatic Nerve Mobility Exercises on Hamstring Length in Collegiate Students With Hamstring Tightness - A Randomized Controlled Study.

This study included collegiate students with tight hamstring muscles aged between 18-23 recruited from the Gulf Medical University, Ajman, UAE to compare the effectiveness of modified sciatic nerve mobility exercises and dynamic hamstring muscle stretching (DHMS) on hamstring length in collegiate students with hamstring muscle tightness.

Study Overview

• Status: Completed
• Conditions: Hamstring Tightness
• Intervention / Treatment: Procedure: Modified sciatic nerve mobility exercises; Procedure: Dynamic hamstring muscle stretching

Detailed Description

Hamstring Muscle Tightness is a common musculoskeletal condition that affects a significant proportion of the general population, particularly among collegiate students. Among the student population, sitting for longer periods during college hours is the primary cause of HMT. Evidence suggests that stretching with a combination of manual or instrument-assisted soft tissue mobilization are effective in improving hamstring muscle flexibility among individuals with HMT. A meta-analysis demonstrated a significant improvement in knee extension ROM and straight leg raise test measures following neural mobilization treatment which support the effectiveness of neural mobilization treatment in enhancing hamstring flexibility compared to muscle inhibition and stretching techniques . Especially, neural glides and neural stretching designed to restore the overall balance in the nervous system and can increase hamstring muscle flexibility, making them valuable interventions for individuals with HMT. A study on hamstring muscle flexibility in relation leg rotation suggest that hamstring stretching is enhancing the leg rotation and hamstring lengthening. Thus, dynamic stretching targeting the nerves and muscles is warranted for the treatment of tight hamstring in the general population, especially among collegiate students. This evidence provides input for the modification of dynamic sciatic nerve stretching to improve the effects of therapeutic interventions that focus on neuromuscular flexibility, joint ROM, and pain relief. Further evidence also suggests that nerve-directed stretching is superior to muscle-directed stretching in improving hamstring tightness in healthy adults. However, the role of nerve-directed dynamic stretching with hip rotation has not been addressed by previous interventional studies. Therefore, This study compared the effects of modified sciatic-nerve mobility exercises over dynamic hamstring muscle stretching on improving the hamstring length in collegiate students with HMT to determine the most effective approach for managing this condition.

• Study Type: Interventional
• Enrollment (Actual): 94
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United Arab Emirates
  • Ajman, United Arab Emirates, 4184
    • Gulf Medical University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Collegiate students with hamstring muscle tightness.
• Unilateral and/or bilateral hamstring muscle tightness.
• Students from the Gulf Medical University.

Exclusion Criteria:

• History of intervertebral disc lesions and radiculopathies,
• Soft tissue injuries in the lower extremity.
• Spine surgery, lower extremity neurological complications.
• Students engaged in competitive sports.
• Students engaged in other interventional studies.
• Lower back pain from specific causes.
• Pelvic inflammatory conditions.
• Unwillingness to provide informed consent.
• Nutritional deficiencies.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group 1: MSNM; The participants in this group are treated with modified sciatic nerve mobilization.	Procedure: Modified sciatic nerve mobility exercises; Each participant was made to lie down in a supine position on the treatment couch. The participant's leg was moved to about 30-45 degrees hip flexion with knee extension. The ankle was then moved to maximum dorsiflexion with inversion and hip internal rotation within the participant's tolerance, and this position was maintained for 30 seconds. While the therapist performed dorsiflexion with inversion and hip internal rotation in the supported straight leg raise position, the participant was instructed to actively flex the cervical spine slowly until they perceived a tolerable stretch sensation in the hamstring muscle and lower leg. The synchronous alternating movements were performed rhythmically for 10-15 repetitions. This maneuver was repeated 3 times in a single session, 3 days per week, and continued for 3 consecutive weeks.
Active Comparator: Group 2: DHMS; The participants in this group are treated with dynamic hamstring muscle stretching.	Procedure: Dynamic hamstring muscle stretching; The participant was instructed to stand straight with the unaffected foot supported on the floor and the toes pointing forward. The heel of the testing leg was placed on an 18" high step with the toes directed upwards with knee extension. Once cued, the participant was asked to flex forward at the hip while maintaining the spine in a neutral position and reaching the arms forward. The knee joint remained fully extended as the participant continued to flex the hip until a gentle stretch was felt in the posterior thigh. Once the position was achieved, the participants were asked to hold it for 20-30 seconds. The same procedure was repeated 3 times daily, 3 days a week for three consecutive weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Passive Knee Extension (PKE) ROM test	To measure the hamstring length using Passive Knee Extension (PKE) ROM test, the participant was in supine position on the plinth, the hip and knee of the lower limb to be tested kept at 90° flexion.	Baseline, post-treatment day 1, end of week 1, and week 2

Collaborators and Investigators

• Sponsor: Gulf Medical University
• Investigators: Study Chair: Ramprasad Muthukrishnan, PhD, Gulf Medical University

Study record dates

Study Major Dates

• Study Start (Actual): March 14, 2023
• Primary Completion (Actual): July 30, 2023
• Study Completion (Actual): August 16, 2023

Study Registration Dates

• First Submitted: September 15, 2024
• First Submitted That Met QC Criteria: September 17, 2024
• First Posted (Actual): September 19, 2024

Study Record Updates

• Last Update Posted (Estimated): November 7, 2024
• Last Update Submitted That Met QC Criteria: November 6, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: Muscle stretching; neural mobilization; Hamstring tightness; Neurodynamic
• Other Study ID Numbers: IRB-COHS-STD-34-MAR-2023

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The data may be provided based upon request related to research purpose

Drug and device information, study documents

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