Comparative Analysis of DS and NMT on Pelvic Inclination in Early Middle-Aged Patients With Radicular Low Back Pain

Comparative Analysis of Dynamic Stretching and Neural Mobilization Techniques on Pelvic Inclination in Early Middle-Aged Patients With Radicular Low Back Pain

Radicular low back pain (RLBP) is a common and debilitating condition characterized by nerve root irritation or compression, often resulting in altered biomechanics, muscular imbalances, and postural deviations such as anterior pelvic tilt.

Study Overview

• Status: Active, not recruiting
• Conditions: Low Back Pain
• Intervention / Treatment: Diagnostic test: Dynamic Stretching Protocol; Combination product: Neural Mobilization Technique Protoco

Detailed Description

Rehabilitation strategies commonly focus on improving flexibility, neuromuscular control, and nerve mobility. Among these, dynamic stretching and neural mobilization techniques have shown individual effectiveness, but limited evidence exists on their comparative or combined effects on pelvic alignment and functional outcomes, particularly in early middle-aged adults. Addressing this gap could support the development of more targeted, evidence-based rehabilitation protocols.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Sindh
    • Hyderabad, Sindh, Pakistan
      • Private clinic Hyderabad Sindh

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Both Male and Female
• Early middle-aged adults (aged 35-55 years)
• Diagnosed with radicular low back pain (RLBP) lasting more than 4 weeks
• Positive Straight Leg Raise (SLR) or Slump test
• Able to participate in physical therapy sessions 3 times/week(26)

Exclusion Criteria:

• History of spinal surgery or fractures
• Severe neurological deficits (e.g., foot drop, bladder/bowel dysfunction)
• Diagnosed with inflammatory or systemic conditions (e.g., ankylosing spondylitis, rheumatoid arthritis)
• Concurrent participation in other physical therapy programs
• Pregnant women or individuals with severe cardiovascular conditions

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Dynamic Stretching Protocol	Diagnostic test: Dynamic Stretching Protocol; Participants assigned to Group A will undergo a structured dynamic stretching protocol, designed to enhance lumbar flexibility, core muscle activation, and postural alignment, specifically targeting the pelvic inclination associated with radicular low back pain (RLBP). The intervention will be administered three times per week under the direct supervision of a qualified physiotherapist. Each session will last for 30 minutes, beginning with a 5-minute warm-up involving light aerobic activity such as marching or gentle trunk rotations to prepare the body for movement. This will be followed by 20 minutes of dynamic stretching exercises, focusing on the major muscle groups that influence pelvic and lumbar mobility.
Active Comparator: Neural Mobilization Technique Protocol	Combination product: Neural Mobilization Technique Protoco; Participants in Group B will receive a standardized neural mobilization intervention, targeting the sciatic nerve and lumbar plexus, known to contribute to pain and restricted mobility in radicular low back pain (RLBP). The treatment will be conducted three times per week, with each session lasting 30 minutes under the guidance of an experienced physiotherapist trained in neurodynamic techniques. The session will begin with a 5-minute preparatory phase to position the participant comfortably and explain the sequence of movements. This will be followed by 20 minutes of gentle neural mobilization techniques, including nerve sliders and tensioners, performed through movements such as the Straight Leg Raise (SLR) sliders and the Seated Slump mobilization technique.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analog Scale (VAS)	The Visual Analog Scale (VAS) is a subjective but highly sensitive tool used for assessing pain intensity in clinical and research settings. It consists of a 10- centimeter horizontal line with endpoints labeled "0 = No pain" and "10 = Worst imaginable pain." Participants will be instructed to mark a point on the line that best reflects the intensity of their current pain, both at rest and during movement. The distance (in centimeters) from the "no pain" anchor to the marked point is then measured and recorded as the pain score.	12 Months
Modified Schober Test	It is a reliable and simple clinical method used to assess lumbar spine flexibility, particularly in the sagittal plane. It measures the extent of lumbar flexion by quantifying the increase in distance between two anatomical landmarks during forward bending. To perform the test, the examiner marks a point at the level of the posterior superior iliac spines (PSIS), which corresponds approximately to the L5 vertebra. A second mark is made 10 cm above and a third mark 5 cm below the initial point. The participant is then asked to bend forward as far as possible while keeping the knees straight.	12 Months

Collaborators and Investigators

• Sponsor: Superior University

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2025
• Primary Completion (Estimated): July 1, 2025
• Study Completion (Estimated): February 28, 2026

Study Registration Dates

• First Submitted: May 21, 2025
• First Submitted That Met QC Criteria: May 21, 2025
• First Posted (Actual): May 30, 2025

Study Record Updates

• Last Update Posted (Actual): May 30, 2025
• Last Update Submitted That Met QC Criteria: May 21, 2025
• Last Verified: May 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Back Pain; Low Back Pain
• Other Study ID Numbers: MSRSW/Batch-Fall23/826

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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