Effect of Sciatic Nerve Neurodynamic Sliding on Pain, Disability, and Balance in Patients With Lumbar Radiculopathy

Официальное название

Effect of Sciatic Nerve Neurodynamic Sliding Technique on Pain, Disability, and Balance in Patients With Lumbar Radiculopathy

Обзор

This study will be conducted to evaluate the effect of sciatic nerve slider mobilization on pain intensity. Also, to evaluate the impact of sciatic nerve mobilization on functional disability, and to determine the influence of sciatic nerve slider neurodynamics on functional balance performance.

Подробное описание

Radicular pain in lumbar radiculopathy is a mixture of nociceptive and neuropathic component. Several conservative treatments are available to treat lumbar radiculopathy: moderate evidence (Level B) of effectiveness for the conservative treatment: patient education and self-management, McKenzie method, mobilization and manipulation, exercise therapy, traction (short-term outcomes), neural mobilization, and epidural injections. Two interventions were identified to have weak evidence of effectiveness (Level C): traction for long-term outcomes and dry needling. Three interventions were identified to have conflicting or no evidence (Level D) of effectiveness: electro-diagnostic-based management, laser and ultrasound, and electrotherapy. The efficacy of individual treatment is controversial; a multimodal approach is recommended because it is more effective. However, little high-quality evidence supports the use of conservative treatment.

As well as being amongst the manual therapy techniques recommended to improve patients' pain and disability, neural mobilization (NM) has also been advocated as an analgesic treatment option. NMs are techniques that involve a specific sequence of joint movements to mobilize the involved peripheral nerve in order to enhance nerve gliding and reduce the neural mechanosensitivity.

This study will provide further insight into the efficacy of sciatic nerve neurodynamic Slider technique in reducing pain, improving functional outcomes, and balance, offering a cost-effective management strategy for affected individuals.

Вмешательства

• Другое Selected conventional physical therapy program
  The program will include: 1- Transcutaneous electrical nerve stimulation (TENS) will be applied at Lumbosacral area, with pulse frequency of 100 Hz for 15 minutes. 2\) Manual therapy intervention: Myofascial release will be performed on low back muscles and gluteus, piriformis, hamstring, and calf of the affected lower extremity applied for 20 minutes. Following side posture positional distraction, the wedge pillow will be removed and the patient is maintained in the same position. The physica
• Другое Sciatic nerve slider mobilization
  Mobilization will be applied from supine position, alternating hip flexion with knee extension and dorsiflexion, and knee flexion with plantar flexion, performed three times for 1 minute straight leg raising technique rhythmically

Первичные конечные точки

• Pain pressure threshold [Срок оценки: 6 weeks]
• Functional Disability [Срок оценки: 6 weeks]
• Balance Evaluation [Срок оценки: 6 weeks]

Критерии участия

Критерии включения

• Chronic unilateral lumbar painful radiculopathy (duration ranged from 3 to 18 months).
• During the evaluation session, repeated lumbar movements did not improve or worsen lower extremity symptoms.
• Positive straight leg raise (SLR) response. A positive SLR test was defined as the presence of both of these findings: (1) the test reproduced the patient's symptoms and (2) the symptoms decreased with the ankle plantar flexion component of the test.
• Unilateral Pain radiating below the knee, with leg pain equal to or more severe than the accompanying back pain.
• The presence of paresthesia such as pins and needles or numbness in the affected limb, along with neurological deficits-whether motor, sensory, or reflex-that corresponded to the dermatome or myotome of the affected nerve root.

Критерии исключения

• Systemic diseases such as autoimmune and metabolic diseases.
• Previous Lumbar Spine surgery.
• Lumbar spine stenosis.
• Spinal deformity.
• Spinal fracture.
• Bilateral lower extremity symptoms.
• Steroid injection or use of anti-inflammatory medications within two to four weeks prior to study commencement.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Египет · 1 центр

• Abdelrahman Taha El-sayed — Suez

Идентификаторы

NCT: NCT07458399 · P.T.REC/012/006269

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗