Effects of Neurodynamic Mobilization and Stretching Exercises for Chronic Discogenic Sciatica (NDM)

Cairo University (CU)

Status: Completed

Conditions: Physical Therapy

Treatments: Other: Slider, tensioner neurodynamic mobilization techniques and stretching exercises of back, hamstrings and gastrocnemius

Study type: Interventional

Funder types: Other

Identifiers

NCT04746690

P.T.8/8/93

Details and patient eligibility

About

This study compares between neurodynamic mobilization and stretching exercises in treatment of chronic dicogenic sciatica

Full description

This study was conducted at the outpatient clinics, faculty of physical Therapy, Kafrelsheikh University to compare between the effects of slider, tensioner neurodynamic mobilization techniques and stretching exercises on pain, Range of motion (ROM) and functional disability for patients with chronic discogenic sciatica.

Design of the study:

A pre-test post-test three-armed comparative study design was used for comparison between the effects of slider, tensioner neurodynamic mobilization techniques and stretching exercises for patients with chronic discogenic sciatica.

Selection of patients:

Sample size:

Using G-power software program and regarding F test study , alpha level of 0.05, confidence interval 95% and effect size of 0.25 (to detect small effects ), three groups and 6 dependent variables, the total sample size will be 36 patient (twelve in each group).

To reach the specific sample size, forty-three patients were screened regarding the inclusion/exclusion criteria. Thirty-six patient with unilateral chronic discogenic sciatica from both sexes (....male and ... female) were recruited from the outpatient clinics, faculty of physical Therapy, Kafrelsheikh University. Their age ranged between 21-50 years.

They were randomly allocated by simple random method; to avoid selection bias, patients were asked to choose a card of three wrapped cards representing the three treatment groups:

Group (A): received Slider technique only. Group (B): received Tensioner technique only. Group (C): received Stretching exercises of back extensors, hamstrings and gastrocnemius muscles only.

Enrollment: 36 patients

Sex: All

Ages: 21 to 50 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Patients diagnosed by magnetic resonance imaging (MRI) confirming disc lesion.
2. Radicular pain for at least twelve weeks up to one year with no acute episodes for the last four weeks.
3. Positive slump test, with reproduction of neurological symptoms.
4. Ages of 21-50 years of both sexes.
5. Patients with functional disabilities e.g. during lifting or walking

Exclusion criteria

1. Patients with sciatica due to other pathologies e.g. lumbar canal stenosis or piriformis syndrome.
2. Patients after any spinal surgery e.g. unilateral hemilaminectomy or microdiscectomy
3. Negative slump test.
4. Progressive neurological symptoms e.g. hyperirritable and unstable symptoms.
5. History of vertebral fracture or trauma.
6. Systemic disorder e.g. diabetes mellitus.
7. Pregnant women.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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36 participants in 3 patient groups

Slider neurodynamic mobilization technique only

Active Comparator group

Description:

a neurodynamic mobilization technique of the sciatic nerve with stretch on one nerve end and slackness on the other end.

Treatment:

Other: Slider, tensioner neurodynamic mobilization techniques and stretching exercises of back, hamstrings and gastrocnemius

Tensioner neurodynamic mobilization technique only

Active Comparator group

Description:

a neurodynamic mobilization technique of the sciatic nerve with stretch of both nerve ends.

Treatment:

Other: Slider, tensioner neurodynamic mobilization techniques and stretching exercises of back, hamstrings and gastrocnemius

Stretching exercises of back extensors, hamstrings and gastrocnemius muscles

Active Comparator group

Description:

Stretching exercises of back extensors, hamstrings and gastrocnemius to relief the pressure on the nerve.

Treatment:

Other: Slider, tensioner neurodynamic mobilization techniques and stretching exercises of back, hamstrings and gastrocnemius