Efficacy of Adding Neural Mobilization Techniques in Patients With Cervical Radiculopathy

April 6, 2026 updated by: Hiba Mohammad Hasan, Cairo University

Effectiveness of Slider and Tensioner Neurodynamic Mobilization Techniques in Patients With Cervical Radiculopathy: A Randomized Controlled Trial

The goal of this randomized controlled trial is to investigate the effects of adding slider neural mobilization technique compared to tensioner neural mobilization technique to conventional physical therapy treatment on pain, function, cervical range of motion, hand grip strength, and electrophysiological parameters of the median nerve in patients with cervical radiculopathy.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Cervical radiculopathy (CR) is a condition where the nerve root of a spinal nerve is compressed or impaired, causing the pain and symptoms to spread beyond the neck, radiating to the shoulder, and upper limb. Cervical radiculopathy primarily results from an impingement and inflammation of a nerve root induced by a space-occupying lesion that reduces the size of the intervertebral foramen, as a degenerative lesion of the zygapophyseal joint, or it is associated with a cervical disc derangement.

Patients presenting with CR complain of neck, periscapular, and radicular pain into the hand and arm. As well as neurologic symptoms such as sensory disturbances (paresthesia or numbness), muscle weakness with reduced tendon reflexes in the affected nerve root, or a combination of these signs and symptoms.

The reported annual incidence of CR is 85 cases per 100,000 people in the population, while the prevalence is 3.5/1000 persons. The C7 nerve root is most frequently impacted, with more than half of all cases affecting this level.

Several studies utilized therapeutic exercises, manual therapy, other modalities, cervical collars, cervical traction, postural education, and different medications such as drugs and steroid injections in the conservative management for cervical radiculopathy in its different stages.

The neural mobilization (NM) is a manual therapy method that improves neural flexibility, lowers dynamic sensitivity of the nervous system, increases blood flow, and relieves pain; for that, improved neural mobility and alleviated pain increase joint range of motion (ROM).

The NM techniques are delivered by two techniques, "sliding/gliding" and "tensioning." Tensioner technique generate tension from both ends of the nerve, while sliders involve gliding of the nerve relative to its surrounding structures by performing joint movements that elongate the nerve bed with minimal strain. In addition, sliders are usually less aggressive than tensioners, and their use might be indicated at early disease stages.

Both techniques aid in preventing the formation of adhesions, reducing endoneurial pressure, reducing intraneural edema, increasing nerve oxygenation, and decreasing ischemic pain.

Studies that used sliders and tensioners techniques in their clinical studies showed significant changes in biomechanical factors such as patients' self-reports of pain, disability, ROM, endurance, and muscle strength in the management of musculoskeletal neck disorders with nerve-related symptoms.

Therefore, what are the possible effects of adding the tensioner neural mobilization technique versus the slider neural mobilization technique to conventional physical treatment in treating patients with cervical radiculopathy?

Study Type

Interventional

Enrollment (Actual)

36

Phase

  • 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 Locations

  • Egypt
    • Cairo Governorate
      • Cairo, Cairo Governorate, Egypt
        • Cairo University

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

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Current continuous or intermittent pain that has persisted for more than 3 months.
  2. Motor, reflex, and/or sensory changes in the upper limb.
  3. Both genders aged 30-50 years.
  4. Three positive special tests out of five as a predefined diagnostic criterion from the following tests: Upper Limb Neural Tension A (ULNT) test for the median nerve, Spurling's test, compression test, cervical distraction test, less than 60° cervical rotation towards the symptomatic side, and Valsalva maneuver.
  5. A motor nerve conduction study, F wave, and H reflex were performed in the involved limb to confirm CR.

Exclusion Criteria:

  1. History of surgical procedures for cervical or upper extremity.
  2. Clinical signs or symptoms of medical red flags (infection, cancer, and cardiac involvement).
  3. Patients with neck pain for signs and symptoms of serious pathology, upper cervical ligamentous insufficiency, unexplained cranial nerve dysfunction, and spinal fractures.
  4. Any systematic disease such as rheumatism and tuberculosis, cervical myelopathy, or multiple sclerosis.
  5. Systemic disease is known to cause generalized peripheral neuropathy, such as diabetes mellitus.
  6. Complete loss of sensation along the involved nerve root.
  7. Upper limb compression syndrome, such as thoracic outlet syndrome, carpal tunnel syndrome, and pronator syndrome.
  8. Pregnant woman.
  9. Patients who have received any physical therapy of the cervical region in the past 3 months.

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: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Control group A (conventional treatment)
Conventional treatment, including hot pack, stretching of the neck muscles, cervical isometrics exercise.
Other: Conventional treatment
hot pack, stretching of the neck muscles, cervical isometrics exercise
Experimental: Experimental group B (Tensioning neural mobilization with addition to conventional treatment)
Median nerve neural tensioning mobilization with addition to conventional treatment
Other: Tensioner Neuro Dynamic Mobilization
Median nerve tensioner neural mobilization with addition to conventional treatment
Experimental: Experimental group C (Sliding neural mobilization with addition to conventional treatment)
Median nerve sliding neural mobilization with addition to conventional treatment
Other: Slider Neuro Dynamic Mobilization
Median nerve neural sliding mobilization with addition to conventional treatment

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual Analogue Scale
Time Frame: At baseline, to the end of treatment at 4 weeks.
to measure neck pain with score extended from 0 to 10, minimum score 0 (no pain), highest score 10 (worst pain).
At baseline, to the end of treatment at 4 weeks.
The Arabic Version Of Neck Disability Index
Time Frame: At baseline, to the end of treatment at 4 weeks.
to assess the level of disabilities in patients with neck pain, in % points.
At baseline, to the end of treatment at 4 weeks.
Cervical Range of Motion
Time Frame: At baseline, to the end of treatment at 4 weeks.
to measure the full cervical rotation using CROM device in degrees
At baseline, to the end of treatment at 4 weeks.
Hand Grip Strength
Time Frame: At baseline, to the end of treatment at 4 weeks.
to measure hand grip strength using hydraulic dynamometer, in kilogram.
At baseline, to the end of treatment at 4 weeks.
Nerve Conduction Study
Time Frame: At baseline, to the end of treatment at 4 weeks.
Motor conduction study for the median nerve, to measure conduction velocity (m/second), distal latency (ms), and amplitude(mV).
At baseline, to the end of treatment at 4 weeks.
F wave
Time Frame: At baseline, to the end of treatment at 4 weeks.
F wave for the median nerve to measure latency (ms).
At baseline, to the end of treatment at 4 weeks.
H-Reflex
Time Frame: At baseline, to the end of treatment at 4 weeks.
H-Reflex for the median nerve to measure latency (ms), amplitude (mV), H-R ratio (%).
At baseline, to the end of treatment at 4 weeks.

Collaborators and Investigators

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

Sponsor

Cairo 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)

November 15, 2024

Primary Completion (Actual)

March 15, 2025

Study Completion (Actual)

April 15, 2025

Study Registration Dates

First Submitted

October 21, 2024

First Submitted That Met QC Criteria

October 27, 2024

First Posted (Actual)

October 29, 2024

Study Record Updates

Last Update Posted (Actual)

April 9, 2026

Last Update Submitted That Met QC Criteria

April 6, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • P.T.REC/012/005270

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

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.

Clinical Trials on Cervical Radiculopathy

Clinical Trials on Conventional treatment

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Senegal

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe