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

21. juli 2026 oppdatert av: 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.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Antatt)

52

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Rekruttering
        • Femwell Physiocare Woman Rehab clinic
        • Ta kontakt med:

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:

  • 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.

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
Eksperimentell: 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.
Annen: 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
Aktiv komparator: 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)
Annen: 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

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
NPRS for pain
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Riphah International University

Etterforskere

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

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

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 (Faktiske)

20. juni 2026

Primær fullføring (Antatt)

20. august 2026

Studiet fullført (Antatt)

20. september 2026

Datoer for studieregistrering

Først innsendt

21. juli 2026

Først innsendt som oppfylte QC-kriteriene

21. juli 2026

Først lagt ut (Faktiske)

24. juli 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

24. juli 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

21. juli 2026

Sist bekreftet

1. juli 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • REC/RCR&AHS/25/0132 Muniba

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