Comparative Effects of Mulligan Bent Leg Raise Versus Spinal Mobilization With Leg Movement in Lumbar Radiculopathy

July 21, 2026 updated by: Riphah International University

Comparative Effects of Mulligan Bent Leg Raise Versus Spinal Mobilization With Leg Movement on Pain, Neural Mobility, Balance and Functional Disability in Lumbar Radiculopathy

Lumbar radiculopathy is a spinal nerve root disorder often caused by lumbar disc herniation or compression, leading to radiating leg pain, restricted movement, and functional difficulties. This condition significantly disrupts daily activities and overall quality of life. While medication and exercise are common treatments, manual therapy techniques are gaining recognition for their non-invasive and effective outcomes in relieving symptoms and improving patient function.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This randomized clinical trial will be conducted in Physiotherapy outpatient department of Jinnah Hospital Lahore. It will include 52 participants, aged 20 to 40 years, meeting clinical criteria for lumbar radiculopathy. Participants will be selected from an outpatient physiotherapy department and assigned randomly into two equal groups. Group A will receive the MBLR technique, while Group B will undergo the SMWLM technique. Both interventions will be applied three times a week for four weeks under standardized protocols. Key outcome measures include pain intensity assessed using the Numeric Pain Rating Scale (NPRS), neural mobility evaluated through the Straight Leg Raise (SLR) and Slump Test, and functional status measured using the Oswestry Disability Index (ODI), Timed Up and Go (TUG) test, and 5 Repetition Sit-to-Stand test for postural balance. Assessments will be conducted at baseline, after 2 weeks, at 4 weeks post-intervention, and at 8-week follow-up. Data analysis will be done by SPSS version 25. To ensure objectivity, all assessments will be conducted while keeping the patient unaware of their group assignment.

Study Type

Interventional

Enrollment (Estimated)

52

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 Contact

Study Contact Backup

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Recruiting
        • Femwell Physiocare Woman Rehab clinic
        • Contact:

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:

  • Age 20 to 40 years (26)
  • Diagnosed patient with Unilateral Lumbar Radiculopathy secondary to L4/L5 and L5/S1 lumbar posterolateral disc buldge confirmed on MRI (12)
  • Posterolateral Lumbar Radiculopathy

Exclusion Criteria:

  • • Presence of red flags (e.g., cauda equina syndrome, severe neurological deficits).

    • Previous spinal surgery within 1 year.
    • Severe osteoporosis or vertebral fractures.
    • Pregnant women.
    • Systemic inflammatory or autoimmune diseases.

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: Mulligan Bent Leg Raise (MBLR)
The Mulligan Bent Leg Raise (BLR) technique is a specialized physical therapy mobilization method used to relieve low back pain, reduce sciatica, and improve hamstring flexibility. It involves applying gentle, pain-free traction while moving the leg through progressively greater ranges of hip flexion.
Other: Mulligan Bent Leg Raise (MBLR)

Patient Position - Supine at edge of plinth

  • Affected hip and knee flexed to 90°
  • Hand of affected side under head and neck Therapist Position - Stands in walk stance, lateral to affected limb Therapist Hand Placement - Inner shoulder under popliteal fossa
  • Both hands grasp lower thigh Mobilization Procedure - Apply longitudinal traction along femur
  • Flex hip toward same side shoulder until first resistance
  • Patient performs isometric hold (5 sec)
  • On relaxation, increase hip flexion if pain free
  • Hold new position ~20 sec
  • Repeat 3 times if tolerated Precautions - Maintain knee flexion
  • No need to stabilize opposite leg
Active Comparator: Spinal Mobilization with Leg Movement (SMWLM)
Spinal Mobilization with Leg Movement (SMWLM) is an advanced manual therapy technique developed as part of the Mulligan Concept. It integrates manual joint mobilization with neurodynamic principles to treat lower back and radiating leg pain, most notably lumbar radiculopathy (sciatica)
Other: Spinal Mobilization With Leg Movement (SMWLM)

Patient Position - Side-lying on unaffected side near edge

  • Affected leg on top, supported by assistant
  • Hip abducted ~10°, extended; knee flexed ~45° Therapist Position - Primary therapist behind pelvis
  • Assistant supports upper leg during movement Therapist Hand Placement - Supported thumb on spinous process of affected vertebra
  • Gentle transverse pressure maintained throughout movement Mobilization Procedure - Assistant helps patient actively lift leg (SLR)
  • Movement within pain free range
  • If symptoms appear, hold for ~3 sec then return
  • Start with 3 reps; increase to 6 with light overpressure as tolerated Precautions - Stay within non painful range
  • Maintain steady, controlled transverse pressure
  • Avoid excessive force, especially early on

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
NPRS for pain
Time Frame: upto 4 weeks
Pain intensity will be evaluated using the Numeric Pain Rating Scale, which ranges from 0 indicating "no pain" to 10 representing the "worst possible pain." It has shown excellent test-retest reliability, with intraclass correlation coefficients (ICC) ranging between 0.95 and 0.98 in individuals with musculoskeletal conditions
upto 4 weeks
SLR and Slump test for neural mobility
Time Frame: Upto 4 weeks
To assess neural mobility, the Straight Leg Raise and Slump Tests will be employed. These are well-established clinical tools for identifying lumbar nerve root irritation. The SLR test demonstrates strong diagnostic accuracy (~81%) and excellent inter-rater reliability with kappa values above 0.90 and aprox 0.71 for slump test
Upto 4 weeks
Oswestry Disability Index test for functional outcome
Time Frame: Upto 4 weeks
The ODI will be used to determine the level of functional disability associated with lower back pain. It includes 10 items that assess various aspects of daily activity. The tool has proven to be highly reliable (Cronbach's alpha = 0.87) and valid across different patient populations with lumbar spine conditions
Upto 4 weeks
Time up and go (TUG) test for functional outcome
Time Frame: Upto 4 weeks
Balance and functional mobility will be measured using the TUG test, which involves timing a patient as they rise from a chair, walk three meters, turn, return, and sit down. This test is highly reliable (ICC = 0.82 to 0.99) and shows good concurrent validity in both spinal and geriatric populations (34). The cutoff value for balance and functional mobility TUG test is 7.2 sec
Upto 4 weeks
Five repetition sit to stand test
Time Frame: upto 4 weeks
The 5 Rep Sit-to-Stand Test will be used to assess lower limb strength and functional performance. The patient gets to their maximum standing position and then sits back down five times as fast as they can without the use of their hands or arms. It has demonstrated excellent reliability (ICC > 0.90) and shows strong correlation with functional ability (36). The cutoff value is > 10 sec for 5 rep sitting to standing and standing to sitting transition
upto 4 weeks

Collaborators and Investigators

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

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Amna Zia, PhD, King Edward Medical University
  • Principal Investigator: Muniba Tahir, Riphah International University, Lahore Campus

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, 2026

Primary Completion (Estimated)

August 20, 2026

Study Completion (Estimated)

September 20, 2026

Study Registration Dates

First Submitted

July 21, 2026

First Submitted That Met QC Criteria

July 21, 2026

First Posted (Actual)

July 24, 2026

Study Record Updates

Last Update Posted (Actual)

July 24, 2026

Last Update Submitted That Met QC Criteria

July 21, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR&AHS/25/0132 Muniba

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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