Effects of Spinal Mobilization With Leg Movement With and Without Neural Flossing Technique in Lumbar Radiculopathy
8. juni 2026 oppdatert av: Riphah International University
Effects of Spinal Mobilization With Leg Movement With and Without Neural Flossing Technique on Pain, Disability, and Range of Motion in Patients With Lumbar Radiculopathy
Lumbar radiculopathy is a spinal condition caused by compression or irritation of the lumbar nerve roots, leading to radiating leg pain, sensory changes, and functional disability.
It commonly affects middle-aged and older adults, impairing daily activities and quality of life.
Conservative treatments include medication, physiotherapy, and exercise.
Spinal Mobilization with Leg Movement (SMWLM), a Mulligan technique, uses passive vertebral mobilization with active leg motion to reduce nerve compression and improve mobility.
Neural flossing, or neurodynamic mobilization, enhances nerve mobility by promoting gliding of nerve roots, especially in cases of restricted neural movement.
This study aims to evaluate the effects of spinal mobilization with leg movement (SMWLM) with and without neural flossing technique on pain, disability, and range of motion in patients with lumbar radiculopathy.
Studieoversikt
Status
Har ikke rekruttert ennå
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
This single-blinded randomized clinical trial will be conducted at Noor Al-Shifa Hospital, Lahore, over 10 months following ethical approval.
A total of 36 patients (18 in each group) with lumbar radiculopathy will be recruited by using non-probability convenience sampling.
Group A will receive spinal mobilization with leg movement (SMWLM) with neural flossing technique, while Group B will receive spinal mobilization with leg movement (SMWLM) only.
Each group will undergo treatment 3 times per week for 6 weeks, with each session lasting 45 minutes.
Pre- and post-intervention assessments will include pain (NPRS), SLR range of motion (Goniometer), and disability (Modified Oswestry Disability Index).
Data will be analyzed using SPSS version 26
Studietype
Intervensjonell
Registrering (Antatt)
36
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiekontakt
- Navn: Samrood Akram, PhD*
- Telefonnummer: 03324806143
- E-post: samrood.akram@riphah.edu.pk
Studiesteder
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Punjab Province
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Lahore, Punjab Province, Pakistan, 54920
- Physio house (Comprehensive Rehab Center)
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Ta kontakt med:
- Adnan Akram
- Telefonnummer: +92 321 8851888
- E-post: dradnan531@gmail.com
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
Tar imot friske frivillige
Nei
Beskrivelse
Inclusion Criteria:
• Patients aged between 30-50 years (9)
- Both male and female genders
- Patient should have lower back pain radiating to one side with numbness, tingling, and muscle weakness (12)
- Positive Lasegue & slump test
Exclusion Criteria:
Any fracture or other injury
- Any systemic illness
- Any inflammatory disease (Rheumatoid arthritis, gout)
- Disc herniation
- Piriformis syndrome
- Lumbar instability
- Scoliosis
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Enkelt
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Eksperimentell: SMWLM along with neural flossing technique
Spinal Mobilization with Leg Movement (SMWLM) and Neural Flossing are highly effective, conservative physical therapy approaches for managing lumbar radiculopathy (sciatica).
They aim to reduce nerve root compression, disperse neural edema, and restore the healthy gliding of nerves within their surrounding tissues
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The participant will be positioned in side-lying with limb where the pain radiated to on top.
Therapist 1 will stand at the participant's ventral side and apply transverse glide with the thumb on the involved lumbar spinous process.
Therapist 2 will then abduct the affected leg by 10° and take the limb gently into hip flexion with knee extended, while the glide will be sustained continuously by therapist 1.
The entire motion during mobilization will be maintained pain-free.
The participant will be positioned in side-lying with limb where the pain radiated to on top.
Therapist 1 will stand at the participant's ventral side and apply transverse glide with the thumb on the involved lumbar spinous process.
Therapist 2 will then abduct the affected leg by 10° and take the limb gently into hip flexion with knee extended, while the glide will be sustained continuously by therapist 1.
The entire motion during mobilization will be maintained pain-free.
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Aktiv komparator: SMWLM without neural flossing technique
Spinal Mobilization with Leg Movement (SMWLM) is a manual therapy technique developed by Brian Mulligan to treat lumbar radiculopathy.
It combines sustained gliding pressure on the lumbar spine with passive or active straight leg raises to alleviate nerve compression, reduce pain, and restore mobility
|
The participant will be positioned in side-lying with limb where the pain radiated to on top.
Therapist 1 will stand at the participant's ventral side and apply transverse glide with the thumb on the involved lumbar spinous process.
Therapist 2 will then abduct the affected leg by 10° and take the limb gently into hip flexion with knee extended, while the glide will be sustained continuously by therapist 1.
The entire motion during mobilization will be maintained pain-free.
The procedure will be repeated three times as per Mulligans rule of 3, post which the SLR test and NPRS will be re-measured
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Numeric Pain Rating Scale for Pain
Tidsramme: upto 4 weeks
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It is a widely used subjective measure for assessing pain intensity, where patients rate their pain on a scale from 0 (no pain) to 10 (worst imaginable pain).
It has high test-retest reliability (ICC = 0.92) and strong construct validity for acute and chronic musculoskeletal conditions
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upto 4 weeks
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Goniometer for ROM
Tidsramme: Upto 4 weeks
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It is a clinical instrument used to measure joint range of motion in degrees, commonly applied in musculoskeletal assessments.
It demonstrates excellent intra-rater (ICC = 0.95) and inter-rater reliability (ICC = 0.89), with strong validity when compared with digital motion analysis tools
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Upto 4 weeks
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Modfied Oswestry Disability Index for disability
Tidsramme: Upto 4 weeks
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It is a self-reported questionnaire used to assess disability due to low back pain, covering aspects such as pain, mobility, and daily activities.
It is a highly valid tool (construct validity r = 0.75) with excellent reliability (Cronbach's alpha = 0.90, ICC = 0.91), making it one of the most commonly used functional outcome measures in spine-related research
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Upto 4 weeks
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Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Etterforskere
- Hovedetterforsker: Rahat Afzal, MS-OMPT, Governement Teaching Hospital Shahdara Lahore.
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Generelle publikasjoner
- Amjad F, Mohseni-Bandpei MA, Gilani SA, Ahmad A, Hanif A. Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord. 2022 Mar 16;23(1):255. doi: 10.1186/s12891-022-05196-x.
- Soar H, Comer C, Wilby MJ, Baranidharan G. Lumbar radicular pain. BJA Educ. 2022 Sep;22(9):343-349. doi: 10.1016/j.bjae.2022.05.003. Epub 2022 Aug 1. No abstract available.
- Ali MS, Kelini KIS, Elsayed M, Galal DOSM, Abdul-Rahman RS. Prevalence of lumbosacral radiculopathy among physiotherapists of pediatric rehabilitation. Revista iberoamericana de psicología del ejercicio y el deporte. 2024;19(2):184-8.
- Bateman EA, Fortin CD, Guo M. Musculoskeletal mimics of lumbosacral radiculopathy. Muscle Nerve. 2025 May;71(5):816-832. doi: 10.1002/mus.28106. Epub 2024 May 10.
- Pinto MV, Ng PS, Laughlin RS, Thapa P, Aragon Pinto C, Shelly S, Shouman K, Dyck PJ, Dyck PJB. Risk factors for lumbosacral radiculoplexus neuropathy. Muscle Nerve. 2022 May;65(5):593-598. doi: 10.1002/mus.27484. Epub 2022 Jan 22.
- Hincapie CA, Kroismayr D, Hofstetter L, Kurmann A, Cancelliere C, Raja Rampersaud Y, Boyle E, Tomlinson GA, Jadad AR, Hartvigsen J, Cote P, Cassidy JD. Incidence of and risk factors for lumbar disc herniation with radiculopathy in adults: a systematic review. Eur Spine J. 2025 Jan;34(1):263-294. doi: 10.1007/s00586-024-08528-8. Epub 2024 Oct 25.
- Price MR, Mead KE, Cowell DM, Troutner AM, Barton TE, Walters SA, Daniels CJ. Medication recommendations for treatment of lumbosacral radiculopathy: A systematic review of clinical practice guidelines. PM R. 2024 Oct;16(10):1128-1142. doi: 10.1002/pmrj.13142. Epub 2024 Apr 17.
- Wang S, Hebert JJ, Abraham E, Vandewint A, Bigney E, Richardson E, El-Mughayyar D, Attabib N, Wedderkopp N, Kingwell S, Soroceanu A, Weber MH, Hall H, Finkelstein J, Bailey CS, Thomas K, Nataraj A, Paquet J, Johnson MG, Fisher C, Rampersaud YR, Dea N, Small C, Manson N. Postoperative recovery patterns following discectomy surgery in patients with lumbar radiculopathy. Sci Rep. 2022 Jul 1;12(1):11146. doi: 10.1038/s41598-022-15169-8.
- Kim SJ, Jang HY, Lee S-M. Effects of spinal mobilization with leg movement and neural mobilization on pain, mobility, and psychosocial functioning of patients with lumbar disc herniation: A randomized controlled study. Physical Therapy Rehabilitation Science. 2023;12(2):92-104.
- Rakesh R. Effectiveness of Mckenzie Exercises Versus Neural Flossing Technique in Patients with Lumbar Radiculopathy. Indian Journal of Physiotherapy & Occupational Therapy. 2024;18.
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Antatt)
30. mai 2026
Primær fullføring (Antatt)
30. juli 2026
Studiet fullført (Antatt)
30. august 2026
Datoer for studieregistrering
Først innsendt
8. juni 2026
Først innsendt som oppfylte QC-kriteriene
8. juni 2026
Først lagt ut (Faktiske)
12. juni 2026
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
12. juni 2026
Siste oppdatering sendt inn som oppfylte QC-kriteriene
8. juni 2026
Sist bekreftet
1. juni 2026
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- REC/RCR&AHS/25/0124 Ruhma
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Nei
Studerer et amerikansk FDA-regulert enhetsprodukt
Nei
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