Comparative Effects of Dynamic Stretching Versus Slider Neurodynamic Technique In Patients With Lumbar Radiculopathy (DS vs SNT -LR)

April 9, 2026 updated by: University of Lahore

Comparative Effectiveness of Dynamic Stretching Versus Slider Neurodynamic Technique In Patients With Lumbar Radiculopathy : a Randomised Controlled Trail

This study will be a randomised clinical trial conducted at the University of Lahore Teaching Hospital, Lahore, Pakistan. A total of 72 participants will be selected and randomly allocated into two treatment groups (36 participants in each group) using the lottery method. All screened and willing participants who meet the eligibility criteria will be assigned to either Group A or Group B.

Group A will receive dynamic stretching along with routine physiotherapy. Routine physiotherapy will include TENS (15 minutes), hot moist pack (10 minutes), soft tissue mobilisation (5-7 minutes), abdominal bracing, pelvic tilt, and alternate leg extension exercises. The dynamic stretching part will include the slump stretch, cat-camel stretch, hamstring sweeps, child pose stretch, and overhead lateral stretch. Each stretch will be performed in 2 sets of 15-20 repetitions with 1-minute rest between sets. Treatment will be provided four times per week for 6 weeks.

Group B will receive slider neurodynamic mobilisation along with the same routine physiotherapy protocol as group A. Slider neurodynamic mobilisation will be performed in the slump position, sitting at the edge of the plinth with the thighs parallel to each other and arms crossing behind the back. The examiner asked the patient to move actively and conversely from a position of neck and trunk flexion, knee flexion, and plantar flexion, to a position of neck and trunk extension, knee extension, and ankle dorsiflexion with 3 sets of 1-minute sliders and 1-minute rest between sets. Treatment will be provided four times per week for 6 weeks.

All participants will undergo assessments at baseline, at the end of the 3rd week, and at the end of the 6th week.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

  • Screening Participants who meet the inclusion criteria was recruited using a convenience sampling technique. This involves selecting participants who are readily available to participate in the study.
  • Allocation Eligible participants were screened and informed about the study, including its purpose, procedures, potential risks, and benefits. Informed consent was obtained from each participant prior to their formal enrollment in the study.
  • Randomization:

Following the baseline assessment, the randomization was conducted using the Online Randomizer tool (https://www.randomizer.org/). By specifying the group numbers, the number of participants per group, and the total number of participants, unique identification numbers were generated for each participant.

• Blindness: This study was single-blinded; the patients were kept blinded about the study and were not informed about the exercise protocol they received.

• Intervention After taking consent, participants was selected based on the inclusion criteria. Sample of 72 was then be randomly divided into two groups.

All participants received a 35-minute treatment session, 4 days per week for 6 weeks, consisting of 15 minutes of routine physiotherapy and 20 minutes of a specific intervention:

Group A (Dynamic Stretching): Routine physiotherapy included TENS (70 Hz, 100 microseconds) for 15 minutes, hot moist packs for 10 minutes, and core strengthening (pelvic tilts and leg extensions). The main intervention was 20 minutes of dynamic stretching, including the slump stretch(The patient performed a slump stretch, seated with knees bent, extending one leg at a time while flexing the trunk forward to stretch the lumbar nerve roots), cat and camel(The patient alternated between spinal flexion and extension while on hands and knees.), hamstring sweeps(The patient performed dynamic hamstring stretches, sweeping the leg forward and back to increase flexibility in the posterior chain.), child's pose, and overhead lateral stretches(The patient performed a side stretch to target the quadratus lumborum and obliques, releasing tension from the side of the back.). Each exercise was performed for 4 minutes in 2 sets of 10-15 repetitions with 1 minute rest interval.

Group B (Slider Neurodynamic Technique): Routine physiotherapy matched Group A but included 5 minutes of soft tissue mobilization. The main intervention was the Slider Neurodynamic Mobilization (NDM). Patients were seated and performed rhythmic movements: moving from neck/trunk flexion and knee flexion to neck/trunk extension and knee extension. This movement is designed to "slide" the nerve through the spinal canal without over-tensioning it. This was performed in 3 sets of 1-minute intervals.

Clinical assessments for pain (NPRS), disability (MODI), and flexibility (MMST) were recorded at baseline, the 3rd week, and the 6th week to compare the efficacy of the two protocols.

Study Type

Interventional

Enrollment (Actual)

72

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

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 55150
        • University of Lahore Teaching Hospital

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:

- • Participants aged between 25 - 50 years of both genders are included

  • Symptoms that radiate below the buttocks, thigh/ knee, and lower leg for more than 4 weeks.
  • A minimum baseline Pain intensity (NPRS) >4/10. (Morsi et al., 2022)
  • Diagnosis of discogenic low back pain (LBP) confirmed by MRI ( disc bulge, protrusion, and herniation) and referred by an orthopedic physician.
  • LBP due to muscle tightness/ or nerve compression.
  • Had a positive slump test with reproduction of neurological symptoms, and had functional disabilities in certain daily tasks as lifting or walking.

Exclusion Criteria:

  • Patients with lumbar spondylolisthesis.

    • Currently pregnant women or in the early post-partum period.
    • Patients with autoimmune disease (ankylosing spondylitis, RA)
    • Previous history of trauma ( fracture, soft tissue injuries) or spinal surgery (spinal laminectomy).
    • Systemic diseases like cardiovascular disease( unstable angina, uncontrolled cardiac arrhythmias) and metabolic diseases.
    • Contraindication to exercises or usage of TENS (cardiac pacemaker, skin allergies to electrodes).

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Dynamic Stretching + Routine Physiotherapy

Participants in this group will receive Dynamic stretching Includes slump stretch, cat and camel, hamstring sweeps, child pose, and overhead lateral stretch.

Protocol: 2 sets of 10-15 repetitions for 4 minutes with 1-minute rest intervals
Other: Dynamic stretching

Dynamic stretching protocol will include:

  • Slump Stretch (4 minutes): The patient performed a slump stretch, seated with knees bent, extending one leg at a time while flexing the trunk forward to stretch the lumbar nerve roots.
  • Cat and Camel Stretch (4 minutes): The patient alternated between spinal flexion and extension while on hands and knees.
  • Hamstring Sweeps (4 minutes): The patient performed dynamic hamstring stretches, sweeping the leg forward and back to increase flexibility in the posterior chain.
  • Child's Pose Stretch (4 minutes): The patient performed a child's pose stretch to improve flexibility in the lower back and hips.
  • Overhead Lateral Stretch (4 minutes): The patient performed a side stretch to target the quadratus lumborum and obliques, releasing tension from the side of the back.

Each dynamic stretch will be performed as follows:

  • 2 sets of 10-15 repetitions
  • 1-minute rest between sets
  • Performed 3 sessions/week for 6 weeks
Other: Routine physiotherapy

TENS: Conventional Transcutaneous Electrical Nerve Stimulation was applied for 15 minutes (70 Hz frequency, 100 μs pulse width). Two 40×40 mm electrodes were positioned in a crossed pattern bilaterally over the lumbosacral region. A hot moist pack was applied to the lumbosacral and gluteal regions for 10 minutes in prone lying.Strengthening and Stabilization Exercises:

Pelvic tilts were performed in crook-lying with 10-15 second holds. Alternate leg extensions were performed in prone with 10-second holds. Quadriceps and hip adductor/abductor strengthening were completed using isometric contractions (e.g., pillow squeeze)..All exercises were performed in 2 sets of 15-20 repetitions with 1 min rest. and lumbar traction.
Experimental: Slider Neurodynamic Mobilization + Routine Physiotherapy
Participants in this arm will receive Slider Neurodynamic Mobilization (NDM) along with routine physiotherapy. NDM slider techniques will be performed in the slump position according to a standardised protocol ( the patient to move actively and conversely from a position of neck and trunk flexion, knee flexion, and plantar flexion, to a position of neck and trunk extension, knee extension, and ankle dorsiflexion ) protocol: 3 sets of 1 minute slider movement with 1 minute rest interval
Other: slider neurodynamic mobilization
Performed in the slump sitting position. Participants move from neck and trunk flexion with knee flexion and plantar flexion toward neck and trunk extension with knee extension and ankle dorsiflexion. The protocol consists of 3 sets of 1-minute slider movements, each followed by 1 minute of rest.
Other: Routine physiotherapy

TENS: Conventional Transcutaneous Electrical Nerve Stimulation was applied for 15 minutes (70 Hz frequency, 100 μs pulse width). Two 40×40 mm electrodes were positioned in a crossed pattern bilaterally over the lumbosacral region. A hot moist pack was applied to the lumbosacral and gluteal regions for 10 minutes in prone lying.Strengthening and Stabilization Exercises:

Pelvic tilts were performed in crook-lying with 10-15 second holds. Alternate leg extensions were performed in prone with 10-second holds. Quadriceps and hip adductor/abductor strengthening were completed using isometric contractions (e.g., pillow squeeze)..All exercises were performed in 2 sets of 15-20 repetitions with 1 min rest. and lumbar traction.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Intensity (NPRS)
Time Frame: baseline, 3rd week, 6th week
Pain Intensity will n=be measured using the numeric pain rating scale (NPRS) , where participants rate their pain on a scale from 0 to 10 (0= no pain, 10= worst possible pain). the scale will be used to assess changes in pain levels over the duration of the intervention.
baseline, 3rd week, 6th week

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Functional Disability (Modified Oswestry Disability Index -MODI)
Time Frame: baseline,3rd week, 6th week
Functional disability will be measured using the modified oswestry low back pain disability index, a validated questionnaire assessing limitations in everyday activities. scores range from 0-100 % with higher scores indicating greater disability. the measure will be used to determine changes in functional ability.
baseline,3rd week, 6th week
Lumbar Flexion Range of Motion (Modified-Modified Schober Test - MMST)
Time Frame: baseline, 3rd week, 6th week
Lumbar flexion range of motion will be assessed using the Modified-Modified Schober Test (MMST). The test measures the change in distance between two points on the lumbar spine during forward flexion. Increased distance indicates improved lumbar mobility.
baseline, 3rd week, 6th week

Collaborators and Investigators

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

Sponsor

University of Lahore

Collaborators

University of Lahore Hospital (ULH)

Investigators

  • Principal Investigator: Asim Arif, PhD, University of Lahore

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)

June 20, 2025

Primary Completion (Actual)

January 30, 2026

Study Completion (Actual)

February 10, 2026

Study Registration Dates

First Submitted

January 26, 2026

First Submitted That Met QC Criteria

January 26, 2026

First Posted (Actual)

February 3, 2026

Study Record Updates

Last Update Posted (Actual)

April 14, 2026

Last Update Submitted That Met QC Criteria

April 9, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • UOL/IREB/25/09/0043

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

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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