Contralateral Neurodynamic Mobilisation Improves Hamstring Flexibility.

A Randomized Controlled Crossover Trial of Contralateral Limb Neurodynamic Mobilisation on Hamstring Flexibility in Healthy Individuals.

The goal of this clinical trial is to investigate whether single limb neurodynamic mobilizations increase active knee extension (AKE) range of motion (ROM) of the contralateral limb. 20 healthy participants (10 females and 10 males, age; 20.8+1.7 years, height; 1.7+ 0.1m, weight; 76.7+ 15.4kg). AKE was measured pre- and post- intervention and control. The main question it aims to answer are:

It is hypothesized that contralateral neurodynamic mobilization will significantly increase AKE ROM in asymptomatic individuals.

Participants were allocated sequentially in an alternating order to study groups. This method aims to balance group sizes while simplifying the assignment. AKE was measured immediately before and after the allocated condition. One week later, at the same time of day, participants returned to complete the opposing condition following a standardized washout period to minimize carryover effects between conditions.

• Completed a neurodynamic mobilisation on the contralateral limb 6x30seconds, 10 second rest between sets.
• When acting as the control sat quietly for 4 minutes to match the duration of the intervention condition.

Study Overview

• Status: Completed
• Conditions: Range of Motion; Wounds and Injury; Neuromuscular Signs and Symptoms
• Intervention / Treatment: Other: Neurodynamic Hamstring Mobilisation

Detailed Description

This study investigates whether unilateral neurodynamic mobilisation produces measurable changes in active knee extension (AKE) range of motion (ROM) in the contralateral limb. Neurodynamic mobilisation techniques are commonly used to influence the mechanical and physiological behaviour of the peripheral nervous system, and previous research has demonstrated that neurodynamic "slider" techniques can acutely increase ipsilateral hamstring flexibility in asymptomatic individuals. However, the potential for contralateral effects, where treatment applied to one limb results in changes in the opposite limb, has not been directly evaluated using this specific mobilisation approach. The present study addresses this gap by examining whether a single session of unilateral neurodynamic mobilisation alters contralateral AKE performance.

The study was conducted using a counterbalanced crossover design consisting of two separate laboratory sessions: a neurodynamic mobilisation session and a control session. Each participant completed both sessions in a randomised order, with a one-week washout period implemented to minimise potential carry-over effects. All sessions were conducted at the same time of day to reduce variability related to diurnal fluctuations in neuromuscular performance.

During the neurodynamic mobilisation session, participants performed an active neurodynamic sliding technique adapted from previously published protocols. The technique was designed to promote excursion of the sciatic nerve without increasing tensile load. Participants were seated at the edge of a plinth in a flexed spinal posture with the hip and knee flexed and the ankle plantarflexed. From this position, they actively extended the cervical spine, extended the knee, and dorsiflexed the foot before returning to the starting position. Movements were paced using a metronome set at 60 beats per minute, with one full cycle of movement performed per beat. The mobilisation consisted of six sets of 30 seconds, separated by 10-second rest intervals, totalling 90 repetitions. The technique was applied only to the right lower limb.

The control session matched the duration of the mobilisation session but involved no movement. Participants remained seated quietly for four minutes following baseline measurement. This allowed comparison between the effects of the neurodynamic intervention and the passage of time alone.

AKE testing was performed immediately before and after each condition. The test was conducted with the participant lying supine, with the hip and knee of the test limb positioned at 90 degrees using a standardised support. Participants were instructed to actively extend the knee as far as possible while maintaining the hip position. Knee angle was measured using a bubble inclinometer placed on the anterior tibial border. Three measurements were taken at each time point, and the average value was used for analysis. All AKE measurements were performed on the contralateral (left) limb, as the mobilisation was applied to the right limb.

Statistical analysis involved a two-by-two repeated measures analysis of variance to examine the interaction between condition (mobilisation vs control) and time (pre vs post). Normality was assessed using the Shapiro-Wilk test. Post-hoc pairwise comparisons were conducted to explore the direction of significant interactions. Effect sizes were calculated using partial eta squared and Cohen's d. Test-retest reliability of the AKE test was assessed using data from the control condition collected one week apart, enabling calculation of the standard error of measurement (SEM) and minimal detectable change (MDC). These values were used to determine whether observed changes exceeded measurement error at both group and individual levels.

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Healthy University students
• Aged 18-30
• participating in regular physical activity
• No current lower back pain
• No current illness
• No current hamstring injuries.

Exclusion Criteria:

• Participants aged 31 or over
• Did not partake in regular physical activity or
• Experienced lower back pain
• Currently suffering from an illness
• Currently sustained a hamstring injuries

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Neurodynamic Group; The neurodynamic technique was adapted from Castellote-Caballero12. The active neurodynamic sliding technique required the participant to sit on the edge of the bed with their feet off the floor. Participants sat in a slumped position with their thoracic and cervical spine flexed, knees flexed and feet plantar flexed. They then extended their cervical spine, extended their knee and dorsiflexed their foot before returning to the starting position, counting as one repetition. This was performed on the right leg for six sets of 30 seconds with a 10 second rest between sets, using a metronome app (ONYX 3, Apple, California) set at 60bpm. Participants flexed and extended their leg on each metronome beat, completing 90 repetitions in total.	Other: Neurodynamic Hamstring Mobilisation; Sciatic Neurodynamic slider performed on the right leg.
Placebo Comparator: Control Group; Following an initial active knee extension test measurement, participants in the control condition were instructed to sit quietly for 4 minutes to match the duration of the intervention condition.	Other: Neurodynamic Hamstring Mobilisation; Sciatic Neurodynamic slider performed on the right leg.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Active Knee Extension Test	Data will be recorded three times to then take a mean. Active knee extension test will be performed utilising a bubble inclinometer placed on the participants tibial tuberosity. Standardised hip flexion to 90 degrees as the active knee extension is performed.	Baseline (Day 1) and Day 7.

Collaborators and Investigators

• Sponsor: University of Salford
• Investigators: Principal Investigator: Charlotte A Park, MSc, University of Salford

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2016
• Primary Completion (Actual): April 1, 2017
• Study Completion (Actual): December 1, 2017

Study Registration Dates

• First Submitted: June 8, 2026
• First Submitted That Met QC Criteria: June 12, 2026
• First Posted (Actual): June 15, 2026

Study Record Updates

• Last Update Posted (Actual): June 15, 2026
• Last Update Submitted That Met QC Criteria: June 12, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Range of Motion; Cross-Education; Slider; Neuromuscular System
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Wounds and Injuries; Neuromuscular Manifestations
• Other Study ID Numbers: ethics number 1516-280

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