Spine Position and Neural Sensitivity

Not Applicable

Completed

• Conditions: Sciatic Nerve; Nerve Pain; Postural Lordosis
• Interventions: Diagnostic Test: Knee extension angle; Diagnostic Test: Straight Leg Raise; Diagnostic Test: Slump Test; Diagnostic Test: Extended slump test

• Registration Number: NCT05313217
• Lead Sponsor: University of Hartford

Brief Summary

The purpose of this research study is to see if there is a relationship between the tightness of the hamstring muscles (muscles on the back of the thighs), reported sensations related to stretch of the nerves of the lower extremity, and different positions of participants' backs. We will investigate the qualitative differences as provided verbally by participants (sensation felt at maximum knee extension angle) and quantitative differences as provided by surface electromyographic (EMG) measurements of hamstring activity and inclinometer measures of the knee angle.

Detailed Description

The Slump Test, introduced by Maitland in 1978, has been a clinical staple for determining adverse neural tension or altered neurodynamics and neurosensitivity related to intradiscal derangement or stenotic narrowing of the lumbar spine. The slump test is a highly reliable, common clinical tool used to assess neural tissue mechanosensitivity in patients with both spinal and lower limb pain. However, it is unclear if the slump test can be used to differentiate between those with true adverse neural tension compared to those with neurosensitivity due to compression of the neuroforaminal interface. The positioning of the slump test places maximal tension on the neural tissues both caudally and cranially, either reducing knee extension angle (KEA) in the affected side as opposed to the unaffected side, provoking radicular symptoms, or both. Hall's research found that there was mechanical activity in the hamstring muscles that came on with neural tension testing. This finding can be used to objectively assess when a participant is at their peak tolerable limit of neural tension in specific trunk positions during the slump test. Observation and clinical experience suggest there may be a subset of individuals who have increased neural tension in the slump test during spinal extension (shortening of the nerves) as opposed to flexion (stretch of the nerves). To date, there has been little research that has objectively demonstrated how trunk position affects neural tension during the slump test. Our research aims to determine if there is a difference in patient reported symptoms and hamstring activity between trunk flexion and extension during the slump test with healthy, younger individuals with no recent history of low back pain (LBP) or related symptoms. We expect to find a difference in range of motion (ROM), symptoms, and hamstring activity when the slump test is done in spinal flexion as opposed to spinal extension. This research will help to establish the prevalence of greater sensitivity in the extended vs flexed posture and establish a normative set of symptoms as described by healthy individuals.

Study Timeline

• Study Start: 2022-03-28
• Study First Submitted: 2022-03-28
• Study First Submitted QC: 2022-03-28
• Study First Posted: 2022-04-06
• Primary Completion: 2022-07-31
• Study Completion: 2022-07-31
• Status Verified: 2023-05
• Last Update Submitted: 2023-05-09
• Last Update Posted: 2023-05-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

• healthy individuals between the ages of 18 and 65 without low back pain.

Exclusion Criteria

• Known previous diagnoses of sciatica or disc herniation
• Diagnosis of scoliosis
• History of pain in the low back or back of the leg
• History of back surgeries
• Any recent hamstring injuries
• Any recent fractures
• History of osteoporosis
• Have feeling of pins and needles down the leg
• Have a known nervous system disorder
• Have a known systemic inflammatory condition
• Have Rheumatoid Arthritis
• Known history of cardiovascular issues
• Have a known connective tissue disorder
• Bowel/bladder issues
• Are or may be pregnant
• Type 1 or type 2 diabetes mellitus
• Active/history of cancer
• Allergy to adhesives
• Are actively involved in a lawsuit regarding personal bodily injury or receiving workman's compensation
• Currently taking/have recently taken antibiotics known as fluoroquinolones (ie. Cipro, Levaquin, Noroxin)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
neural tension testing	Extended slump test	All participants in this arm will undergo four tests: KEA, SLR, Slump, and Extended Slump
neural tension testing	Straight Leg Raise	All participants in this arm will undergo four tests: KEA, SLR, Slump, and Extended Slump
neural tension testing	Slump Test	All participants in this arm will undergo four tests: KEA, SLR, Slump, and Extended Slump
neural tension testing	Knee extension angle	All participants in this arm will undergo four tests: KEA, SLR, Slump, and Extended Slump

Primary Outcome Measures

Name	Time	Method
Knee Extension Angle	single testing session at enrollment	A measurement of the degree of knee extension achieved during the KEA, Slump, and extended slump tests

Secondary Outcome Measures

Name	Time	Method
EMG activity, biceps femoris	single session at enrollment	surface EMG activity of the biceps femoris during KEA, SLR, slump, and extended slump referenced to hamstring maximal voluntary isometric contraction
qualitative data- extent, nature, and intensity of pain	single testing session at enrollment	for each test, the most distal extent of symptoms and intensity on the 11 point numeric pain rating scale will be collected. Participants will be asked to describe the nature of the symptoms experienced during the test (e.g. stretch, pain, pull, tingle, etc)

Trial Locations

Locations (1)

University of Hartford; 🇺🇸 West Hartford, Connecticut, United States