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Sciatic Neural Mobilization in Lumbar-Related Leg Pain

9 de maio de 2026 atualizado por: Yunus Emre Tutuneken, Istinye University

Immediate Effects of Sciatic Neural Mobilization on Balance and Proprioception in Patients With Low Back Pain and Radiating Leg Pain: A Prospective Randomized Clinical Trial

Low back pain is one of the most prevalent musculoskeletal disorders worldwide and significantly reduces individuals' quality of life, functional capacity, and productivity. Lumbar-related leg pain (LRLP) is observed in a substantial proportion of patients with low back pain and is associated with neurodynamic dysfunctions arising from peripheral nerve sensitization. Although the effects of neural mobilization on pain and functional outcomes have been investigated in the literature, studies examining its short-term effects on balance and proprioception remain limited. Therefore, this study aims to determine the immediate effects of sciatic nerve neural mobilization on balance and proprioception in individuals with LRLP exhibiting peripheral nerve sensitivity.

The study will be designed as a prospective, randomized, controlled clinical trial. Participants will be recruited from individuals presenting to the Istinye University Health Practice and Research Center Hospital who meet the inclusion criteria. Following random allocation, 52 participants will be assigned either to the intervention group (neural mobilization) or the sham group (sham mobilization). In addition to a single-session standard conventional physiotherapy program, each group will receive its respective intervention protocol. Assessments will be conducted at two time points: before treatment and immediately after treatment.

Static and dynamic balance as well as proprioception will be evaluated using the ProKin balance system; muscle mechanical properties will be assessed using the MyotonPRO device; pain threshold will be measured with an algometer; and flexibility will be evaluated using the sit-and-reach test.

Visão geral do estudo

Tipo de estudo

Intervencional

Inscrição (Estimado)

52

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto

Aceita Voluntários Saudáveis

Não

Descrição

Inclusion Criteria:

  • Having low back pain accompanied by radiating leg pain (radicular or pseudoradicular pain) for at least 3 weeks
  • Demonstration of peripheral nerve sensitivity through clinical evaluation and neurodynamic tests
  • Pain intensity of at least 3 on the Visual Analog Scale (VAS)
  • Ability to understand verbal and written Turkish instructions
  • Providing signed informed consent

Exclusion Criteria:

  • Presence of surgical indication due to acute disc herniation or advanced lumbar disc pathology
  • History of spinal surgery or spinal trauma
  • Low back pain associated with other pathologies (e.g., rheumatic diseases, multiple sclerosis, malignancy)
  • Instability conditions such as spondylolysis and spondylolisthesis
  • Pregnancy
  • Obesity (BMI ≥ 30 kg/m²)
  • Orthopedic problems or chronic diseases that may limit exercise participation
  • Physiotherapy or steroid injection treatment within the last 3 months

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Triplo

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Real neural mobilization
Participants in the intervention group will receive sciatic neural mobilization in addition to a single-session standard conventional physiotherapy program. The conventional treatment program will consist of hot pack application, transcutaneous electrical nerve stimulation (TENS), and exercises aimed at improving lumbar muscle activation, flexibility, and proprioceptive awareness. Sciatic neural mobilization will be performed based on controlled neural sliding and tensioning principles along the sciatic nerve, with the aim of enhancing neural mobility, improving neurodynamic mechanisms, and supporting neuromuscular control. All interventions will be administered by experienced physiotherapists according to standardized protocols.
Comparador Falso: Sham neural mobilization
Participants in the sham group will receive the same single-session standard conventional physiotherapy program as the intervention group. In addition, sham sciatic neural mobilization will be applied. In the sham intervention, procedures similar to those used in the intervention group will be performed at a minimal level without producing therapeutic neural tension or sliding effects. This approach is intended to distinguish the specific effects of the intervention from placebo effects. All procedures will be carried out by experienced physiotherapists in accordance with standardized protocols.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Static Balance
Prazo: 30 minute
Static balance will be assessed using the ProKin Balance Assessment System. The ProKin system is a computer-assisted evaluation device equipped with an integrated force platform and motion sensors that objectively measure postural stability, weight distribution, and balance control. During the static balance assessment, participants will stand on a stable platform and will be instructed to maintain a steady posture for 30 seconds under both eyes-open and eyes-closed conditions. Parameters, including sway area and center of pressure path length will be recorded.
30 minute
Dynamic Balance
Prazo: 30 minute
Dynamic balance will also be evaluated using the ProKin Balance Assessment System. The assessment will be performed on a movable platform, where participants will be instructed to maintain balance by targeting the center point with visual feedback. During the evaluation, variables such as platform tilt angle, movement duration, and stability index will be recorded.
30 minute
Proprioception
Prazo: 30 minute
Proprioception will be assessed using the ProKin Balance Assessment System through the evaluation of lower extremity joint position sense. Participants will be asked to complete the circular trajectory determined by the device, and proprioceptive performance will be recorded accordingly.
30 minute

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Muscle Tone
Prazo: 30 minute
Lumbar erector spinae muscle tone will be assessed using the MyotonPRO device. Muscle tone represents the natural oscillation frequency of the muscle at rest and reflects the passive tension state of the muscle tissue. Higher frequency values indicate increased resting muscle tension and altered neuromuscular regulation.
30 minute
Muscle Stiffness
Prazo: 30 minute
Lumbar erector spinae muscle stiffness will be evaluated using the MyotonPRO device. Muscle stiffness refers to the resistance of muscle tissue to external mechanical deformation and provides information regarding the biomechanical properties of the muscle. Increased stiffness values may indicate impaired tissue flexibility and altered viscoelastic behavior.
30 minute
Pressure pain threshold
Prazo: 30 minute
Pressure pain threshold will be assessed using a digital algometer applied bilaterally over the lumbar erector spinae muscle at the L3 level. The device objectively measures the minimum pressure perceived as painful, providing a reliable evaluation of mechanical pain sensitivity and alterations in nociceptive processing in individuals with low back pain.
30 minute
Flexibility
Prazo: 30 minute
Lumbar and hamstring flexibility will be evaluated using the Sit and Reach test with a standardized measurement box. Participants will perform controlled forward trunk flexion while maintaining full knee extension. The maximum reaching distance achieved will be recorded in centimeters, providing a reliable assessment of posterior chain flexibility and lumbopelvic mobility.
30 minute
Global Change Scale (GCS)
Prazo: 30 minute
The GCS will be used to assess the patient's perceived improvement following treatment and their level of satisfaction in comparison with their pre-treatment condition. Patients will be asked to rate the perceived effect of the treatment using a 5-point Likert scale as follows: "-2" (much worse), "-1" (worse), "0" (no change), "+1" (better), and "+2" (much better).
30 minute

Colaboradores e Investigadores

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Patrocinador

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

15 de junho de 2026

Conclusão Primária (Estimado)

15 de outubro de 2026

Conclusão do estudo (Estimado)

15 de outubro de 2026

Datas de inscrição no estudo

Enviado pela primeira vez

9 de maio de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

9 de maio de 2026

Primeira postagem (Real)

15 de maio de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

15 de maio de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

9 de maio de 2026

Última verificação

1 de maio de 2026

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • 20 (Sophies Minde Ortopedi AS)

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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