Comparative Effectiveness of Dynamic Stretching Versus Slider Neurodynamic Technique In Patients With Lumbar Radiculopathy : a Randomised Controlled Trail
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 72
- 试验地点
- 1
- 主要终点
- Pain Intensity (NPRS)
研究概览
简要总结
This study will be a randomised clinical trial conducted at the University of Lahore Teaching Hospital, Lahore, Pakistan. A total of 72 participants will be selected and randomly allocated into two treatment groups (36 participants in each group) using the lottery method. All screened and willing participants who meet the eligibility criteria will be assigned to either Group A or Group B.
Group A will receive dynamic stretching along with routine physiotherapy. Routine physiotherapy will include TENS (15 minutes), hot moist pack (10 minutes), soft tissue mobilisation (5-7 minutes), abdominal bracing, pelvic tilt, and alternate leg extension exercises. The dynamic stretching part will include the slump stretch, cat-camel stretch, hamstring sweeps, child pose stretch, and overhead lateral stretch. Each stretch will be performed in 2 sets of 15-20 repetitions with 1-minute rest between sets. Treatment will be provided four times per week for 6 weeks.
Group B will receive slider neurodynamic mobilisation along with the same routine physiotherapy protocol as group A. Slider neurodynamic mobilisation will be performed in the slump position, sitting at the edge of the plinth with the thighs parallel to each other and arms crossing behind the back. The examiner asked the patient to move actively and conversely from a position of neck and trunk flexion, knee flexion, and plantar flexion, to a position of neck and trunk extension, knee extension, and ankle dorsiflexion with 3 sets of 1-minute sliders and 1-minute rest between sets. Treatment will be provided four times per week for 6 weeks.
All participants will undergo assessments at baseline, at the end of the 3rd week, and at the end of the 6th week.
详细描述
- Screening Participants who meet the inclusion criteria was recruited using a convenience sampling technique. This involves selecting participants who are readily available to participate in the study.
- Allocation Eligible participants were screened and informed about the study, including its purpose, procedures, potential risks, and benefits. Informed consent was obtained from each participant prior to their formal enrollment in the study.
- Randomization:
Following the baseline assessment, the randomization was conducted using the Online Randomizer tool (https://www.randomizer.org/). By specifying the group numbers, the number of participants per group, and the total number of participants, unique identification numbers were generated for each participant.
• Blindness: This study was single-blinded; the patients were kept blinded about the study and were not informed about the exercise protocol they received.
• Intervention After taking consent, participants was selected based on the inclusion criteria. Sample of 72 was then be randomly divided into two groups.
All participants received a 35-minute treatment session, 4 days per week for 6 weeks, consisting of 15 minutes of routine physiotherapy and 20 minutes of a specific intervention:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
盲法说明
This study used a single-blind approach. This means that while the researchers knew which treatment each person was getting, the patients did not know if they were in the "Dynamic Stretching" group or the "Slider Neurodynamic" group. They were not told which exercise protocol was the main focus of the study or which one was expected to be more effective. This helps ensure that the patients' expectations did not influence the results or their reporting of pain levels.
入排标准
- 年龄范围
- 25 Years 至 50 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •- • Participants aged between 25 - 50 years of both genders are included
- •Symptoms that radiate below the buttocks, thigh/ knee, and lower leg for more than 4 weeks.
- •A minimum baseline Pain intensity (NPRS) >4/
- •(Morsi et al., 2022)
- •Diagnosis of discogenic low back pain (LBP) confirmed by MRI ( disc bulge, protrusion, and herniation) and referred by an orthopedic physician.
- •LBP due to muscle tightness/ or nerve compression.
- •Had a positive slump test with reproduction of neurological symptoms, and had functional disabilities in certain daily tasks as lifting or walking.
排除标准
- •Patients with lumbar spondylolisthesis.
- •Currently pregnant women or in the early post-partum period.
- •Patients with autoimmune disease (ankylosing spondylitis, RA)
- •Previous history of trauma ( fracture, soft tissue injuries) or spinal surgery (spinal laminectomy).
- •Systemic diseases like cardiovascular disease( unstable angina, uncontrolled cardiac arrhythmias) and metabolic diseases.
- •Contraindication to exercises or usage of TENS (cardiac pacemaker, skin allergies to electrodes).
研究组 & 干预措施
Slider Neurodynamic Mobilization + Routine Physiotherapy
Participants in this arm will receive Slider Neurodynamic Mobilization (NDM) along with routine physiotherapy. NDM slider techniques will be performed in the slump position according to a standardised protocol ( the patient to move actively and conversely from a position of neck and trunk flexion, knee flexion, and plantar flexion, to a position of neck and trunk extension, knee extension, and ankle dorsiflexion ) protocol: 3 sets of 1 minute slider movement with 1 minute rest interval
干预措施: Routine physiotherapy (Other)
Dynamic Stretching + Routine Physiotherapy
Participants in this group will receive Dynamic stretching Includes slump stretch, cat and camel, hamstring sweeps, child pose, and overhead lateral stretch.
Protocol: 2 sets of 10-15 repetitions for 4 minutes with 1-minute rest intervals
干预措施: Dynamic stretching (Other)
Dynamic Stretching + Routine Physiotherapy
Participants in this group will receive Dynamic stretching Includes slump stretch, cat and camel, hamstring sweeps, child pose, and overhead lateral stretch.
Protocol: 2 sets of 10-15 repetitions for 4 minutes with 1-minute rest intervals
干预措施: Routine physiotherapy (Other)
Slider Neurodynamic Mobilization + Routine Physiotherapy
Participants in this arm will receive Slider Neurodynamic Mobilization (NDM) along with routine physiotherapy. NDM slider techniques will be performed in the slump position according to a standardised protocol ( the patient to move actively and conversely from a position of neck and trunk flexion, knee flexion, and plantar flexion, to a position of neck and trunk extension, knee extension, and ankle dorsiflexion ) protocol: 3 sets of 1 minute slider movement with 1 minute rest interval
干预措施: slider neurodynamic mobilization (Other)
结局指标
主要结局
Pain Intensity (NPRS)
时间窗: baseline, 3rd week, 6th week
Pain Intensity will n=be measured using the numeric pain rating scale (NPRS) , where participants rate their pain on a scale from 0 to 10 (0= no pain, 10= worst possible pain). the scale will be used to assess changes in pain levels over the duration of the intervention.
次要结局
- Functional Disability (Modified Oswestry Disability Index -MODI)(baseline,3rd week, 6th week)
- Lumbar Flexion Range of Motion (Modified-Modified Schober Test - MMST)(baseline, 3rd week, 6th week)