Effects of Spinal Mobilization With Leg Movement With and Without Neural Flossing Technique in Lumbar Radiculopathy
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: SMWLM along with Neural flossing technique, SMWLM without Neural flossing technique.
- Who it may be relevant to
- Registry conditions: Lumbar Radiculopathy. Basic parameters: 30 years — 50 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Pakistan
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
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
Overview
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.
Detailed description
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
Interventions
- Other SMWLM along with Neural flossing technique
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 - Other SMWLM without Neural flossing technique
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
Primary outcome measures
- Numeric Pain Rating Scale for Pain [Time frame: upto 4 weeks]
- Goniometer for ROM [Time frame: Upto 4 weeks]
- Modfied Oswestry Disability Index for disability [Time frame: Upto 4 weeks]
Eligibility criteria
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
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Pakistan · 1 center
- Physio house (Comprehensive Rehab Center) — Lahore
Publications
- 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. PMID 36033931
- 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. PMID 38726566
- 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. PMID 34970748
- 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. PMID 39453541
- 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. PMID 38629664
- 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- PMID 35296293
- 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):111 PMID 35778472
Identifiers
NCT: NCT07646379 · REC/RCR&AHS/25/0124 Ruhma