Hip Abduction and Adduction During Neurodynamic Stretching (HIPROT)

The Acute Effects of Neurodynamic Stretching on the Shear Wave Velocity: the Effects of Hip Adduction and Abduction

Neurodynamic mobilization techniques are widely applied in rehabilitation and physiotherapy to enhance the mobility and function of peripheral nerves. Two main approaches are distinguished : Nerve tensioning and nerve flossing. They both involve proximal and distal joint movements to induce greater neural sliding while avoiding excessive tensile stress. However, contradictory findings following neurodynamic stretching highlighted the current lack of consensus regarding the position that should be used. Moreover, neurodynamic techniques are of interest for patients, it appeared it could also be applied in healthy individuals and more particularly in athletes. Accordingly, the primary objective of the present study was to determine the immediate effect of two hip positions (adduction vs. abduction) during neurodynamic flossing techniques on the sciatic nerve and hamstring tissues using the shear wave elastography (SWE, a form of ultrasonography).

Study Overview

• Status: Recruiting
• Conditions: Control Condition; Stretching
• Intervention / Treatment: Other: Maximal neurodynamic flossing

Detailed Description

Neurodynamic mobilization techniques are frequently applied in rehabilitation settings to enhance the mobility and function of peripheral nerves, particularly in the management of neuropathic pain such as carpal tunnel syndrome, radiculopathies, or sciatica. Two main approaches are distinguished. Nerve tensioning involves maintaining the nerve stretched at the end of the joint range of motion with relatively limited excursion. It is similar to a static stretching intervention but with distal (ankle) and proximal (cervical) tensions. Nerve flossing (also termed gliding or sliders), consists of alternating proximal and distal joint movements to induce greater neural sliding while avoiding excessive tensile stress. Both techniques appear efficient. However, contradictory findings following neurodynamic stretching highlighted the current lack of consensus regarding the angular position that could be used. For instance, hip rotations or hip adduction could impact muscle or nerve tissue changes, particularly in healthy tissues. Moreover, neurodynamic techniques are of interest for patients, it appeared it could also be applied in healthy individuals and more particularly in athletes. Performed in patients, healthy or athletes, no study has compared different hip positions. Accordingly, the primary objective of the present study was to determine the immediate effect of two hip positions (adduction vs. abduction) during neurodynamic flossing techniques on the sciatic nerve and hamstring tissues using the shear wave elastography (SWE, a form of ultrasonography). This method has been shown reliable to provide non-invasive real-time assessments of soft tissues elastic properties.

• Study Type: Interventional
• Enrollment (Estimated): 12
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Nicolas Babault; Phone Number: +33380396743; Email: nicolas.babault@ube.fr
• Study Contact Backup: Name: Carole Cometti; Phone Number: +33389396789; Email: carole.cometti@ube.fr

Study Locations

• France
  • Dijon, France
    • Recruiting
    • Universite Bourgogne Europe - faculty of sports sciences
    • Contact: Nicolas Babault; Phone Number: +33380396743; Email: nicolas.babault@ube.fr

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• healthy
• physical active
• no injuries (lower limb or back pain) in the past 3 months

Exclusion Criteria:

• Specific lower limb (hamstring) injuries in the past 2 years
• Not restraining activity 24h before participation

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

6

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: No intervention (neutral); No intervention with measurements in neutral position
No Intervention: No intervention (adduction); No intervention with measurements in adduction position
No Intervention: No intervention (abduction); No intervention with measurements in abduction position
Active Comparator: Neurodynamic (neutral); The hip was positioned neutral (alignment between the lower limb and the trunk).	Other: Maximal neurodynamic flossing; Neurodynamic flossing was applied at pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. During the neurodynamic conditions, head and ankle movement permitted to mobilize nerve tissues. Flossing is the alternation of these movements every 2 seconds.
Experimental: Neurodynamic (adduction); The hip was positioned in adduction and the neurodynamic stretch was applied.	Other: Maximal neurodynamic flossing; Neurodynamic flossing was applied at pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. During the neurodynamic conditions, head and ankle movement permitted to mobilize nerve tissues. Flossing is the alternation of these movements every 2 seconds.
Experimental: Neurodynamic (abduction); The hip was positioned in abduction and the neurodynamic stretch was applied.	Other: Maximal neurodynamic flossing; Neurodynamic flossing was applied at pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. During the neurodynamic conditions, head and ankle movement permitted to mobilize nerve tissues. Flossing is the alternation of these movements every 2 seconds.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nerve shear wave velocity using elastography in neutral position	Shear wave velocity of the sciatic nerve will be evaluated by using an ultrasound (echography) device with a specific mode called "shear wave elastography". Briefly, the ultrasound probe will deliver an ultrasound wave. The propagation speed (called '"shear wave velocity") will be measured by the same probe. The greater the velocity is, the harder the tissue is. The hip position was neutral (alignment between the lower limb and the trunk).	Before the intervention and at the end (immediately after) the intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hamstring force	Maximal torque during a maximal voluntary hamstring contraction	Before the intervention and at the end (immediately after) the intervention
passive knee extension	The final passive range of motion of the hamstring muscles	Before the intervention and at the end (immediately after) the intervention
Global flexibility	the stand and reach test to evaluate flexibility (in centimeters)	Before the intervention and at the end (immediately after) the intervention
Slump test	Seated flexibility using the slump test (in degrees)	Before the intervention and at the end (immediately after) the intervention
discomfort	rating of perceived discomfort during the intervention (from 1 to 10, no discomfort to maximal discomfort, respectively)	At the end (immediately after) the intervention
Nerve shear wave velocity using elastography in experimental position	Shear wave velocity of the sciatic nerve will be evaluated by using an ultrasound (echography) device with a specific mode called "shear wave elastography". Briefly, the ultrasound probe will deliver an ultrasound wave. The propagation speed (called '"shear wave velocity") will be measured by the same probe. The greater the velocity is, the harder the tissue is. The hip position was the experimental position (i.e., adduction or abduction depending on the randomisation).	Before the intervention and at the end (immediately after) the intervention
Muscle shear wave velocity using elastography in neutral position	Shear wave velocity of the biceps femoris muscle will be evaluated by using an ultrasound (echography) device with a specific mode called "shear wave elastography". Briefly, the ultrasound probe will deliver an ultrasound wave. The propagation speed (called '"shear wave velocity") will be measured by the same probe. The greater the velocity is, the harder the tissue is. The hip position was neutral (alignment between the lower limb and the trunk).	Before the intervention and at the end (immediately after) the intervention
Muscle shear wave velocity using elastography in the experimental position	Shear wave velocity of the biceps femoris muscle will be evaluated by using an ultrasound (echography) device with a specific mode called "shear wave elastography". Briefly, the ultrasound probe will deliver an ultrasound wave. The propagation speed (called '"shear wave velocity") will be measured by the same probe. The greater the velocity is, the harder the tissue is. The hip position was the experimental position (i.e., adduction or abduction depending on the randomisation).	Before the intervention and at the end (immediately after) the intervention
Biceps femoris electromyographic activity	Electromyographic activity of biceps femoris muscle	Before the intervention and at the end (immediately after) the intervention
Semitendinosus electromyographic activity	Electromyographic activity of semitendinosus	Before the intervention and at the end (immediately after) the intervention

Collaborators and Investigators

• Sponsor: University of Burgundy
• Investigators: Principal Investigator: Nicolas Babault, universite bourgogne europe

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2026
• Primary Completion (Actual): February 10, 2026
• Study Completion (Estimated): June 30, 2026

Study Registration Dates

• First Submitted: January 9, 2026
• First Submitted That Met QC Criteria: January 9, 2026
• First Posted (Actual): January 20, 2026

Study Record Updates

• Last Update Posted (Actual): April 28, 2026
• Last Update Submitted That Met QC Criteria: April 27, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: muscle; stiffness; nerve; hip; stretching; flexibility
• Other Study ID Numbers: CEP2601

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: data freely available in online websites

Drug and device information, study documents

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