Acute Effects of Neurodynamic Stretching on Muscle-tendon Complex (ELASTRETCH)

University of Burgundy

Status: Completed

Conditions: Control Condition; Stretching

Treatments: Other: Submaximal neurodynamic flossing; Other: Maximal static stretching; Other: Maximal neurodynamic tensioning; Other: Submaximal neurodynamic tensioning; Other: Maximal neurodynamic flossing; Other: Submaximal static stretching

Study type: Interventional

Funder types: Other

Identifiers

NCT07304765

CEP2204

Details and patient eligibility

About

Neurodynamic mobilization techniques are widely applied in rehabilitation and physiotherapy to enhance the mobility and function of peripheral nerves. Two main approaches are distinguished. Nerve tensioning and nerve flossing. They both involve proximal and distal joint movements to induce greater neural sliding while avoiding excessive tensile stress. However, contradictory findings on neurodynamic techniques highlighted the current lack of consensus regarding these techniques. Moreover, neurodynamic techniques are of interest for patients, it appeared it could also be applied in healthy individuals and more particularly in athletes. Accordingly, the primary objective of the present study was to determine the immediate effect of two neurodynamic mobilization techniques (flossing vs. tensioning) on the sciatic nerve and hamstring tissues using the shear wave elastography (SWE, a form of ultrasonography).

Full description

Neurodynamic mobilization techniques are frequently applied in rehabilitation settings to enhance the mobility and function of peripheral nerves, particularly in the management of neuropathic pain such as carpal tunnel syndrome, radiculopathies, or sciatica. Two main approaches are distinguished. Nerve tensioning involves maintaining the nerve stretched at the end of the joint range of motion with relatively limited excursion. It is similar to a static stretching intervention but with distal (ankle) and proximal (cervical) tensions. Nerve flossing (also termed gliding or sliders), consists of alternating proximal and distal joint movements to induce greater neural sliding while avoiding excessive tensile stress. However, contradictory findings on neurodynamic techniques highlighted the current lack of consensus regarding the acute effects of the different possible neurodynamic techniques on sciatic nerves, particularly in healthy tissues. Moreover, neurodynamic techniques are of interest for patients, it appeared it could also be applied in healthy individuals and more particularly in athletes. Performed in patients, healthy or athletes, no study has compared both tensioning or flossing techniques. Moreover, because these techniques involved nerve mobilisation, the intensity should have a main effect of its efficiency. Accordingly, the primary objective of the present study was to determine the immediate effect of two neurodynamic mobilization techniques (flossing vs. tensioning) on the sciatic nerve and hamstring tissues using the shear wave elastography (SWE). This method has been shown reliable to provide non-invasive real-time assessments of soft tissues elastic properties. The secondary aim was to determine the effects of stretching intensity (at the point of pain threshold or below).

Enrollment: 21 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• healthy
• physical active
• no injuries (lower limb or back pain) in the past 3 months

Exclusion criteria

• Specific lower limb (hamstring) injuries in the past 2 years
• Not restraining activity 24h before participation

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Single Blind

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21 participants in 7 patient groups

Control

No Intervention group

Description:

Seated at rest during the same duration than the interventions

Static stretching at pain threshold

Active Comparator group

Description:

Static stretching at pain threshold of the right hamstring muscles 5x60s with 20s rest

Treatment:

Other: Maximal static stretching

Neurodynamic tensioning at pain threshold

Experimental group

Description:

Neurodynamic tensioning of the right hamstring muscles 5x60s with 20s rest at pain threshold

Treatment:

Other: Maximal neurodynamic tensioning

Neurodynamic flossing at pain threshold

Experimental group

Description:

Neurodynamic flossing of the right hamstring muscles 5x60s with 20s rest at pain threshold

Treatment:

Other: Maximal neurodynamic flossing

Static stretching at submaximal intensity

Active Comparator group

Description:

Static stretching of the right hamstring muscles 5x60s with 20s rest at 10% below pain threshold

Treatment:

Other: Submaximal static stretching

Neurodynamic tensioning at submaximal intensity

Active Comparator group

Description:

Neurodynamic tensioning stretching of the right hamstring muscles 5x60s with 20s rest at 10% below pain threshold

Treatment:

Other: Submaximal neurodynamic tensioning

Neurodynamic flossing at submaximal intensity

Active Comparator group

Description:

Neurodynamic flossing stretching of the right hamstring muscles 5x60s with 20s rest at 10% below pain threshold

Treatment:

Other: Submaximal neurodynamic flossing