Effect of Sciatic Nerve Slider Technique in Different Positions in Low Back Pain Patients

NCT ID: NCT05907356

Last Updated: 2024-08-27

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-04-01
• Study Completion Date: 2023-12-25

Brief Summary

Neural mobilization is a technique that plays an important role in repairing the neural tissue's ability to respond to stress or tension by triggering the reconstruction of normal physiological functioning, pain reduction, and functional improvement. The study aims to examine the effect of the sciatic nerve slider technique in different positions and which of the most common positions is more effective in the application of neural mobilization in low back pain with sciatica.

Detailed Description

Low back pain (LBP) is one of the most common musculoskeletal disorders, accounting for a significant portion of disability. It's a severe healthcare burden that has large societal costs, according to estimates, LBP can affect anywhere between 22% and 65% of people within a year. Additionally, back pain-related absences from work result in prolonged periods of sick leave, which has an adverse effect on workplace productivity.

Sciatica is the name given to a collection of symptoms caused by compression and irritation of the sciatic nerve, including pain, numbness, muscular weakness, and difficulty moving or controlling the legs. The lower back, buttocks, and multiple dermatomes of the leg and foot are typically where symptoms appear. Sciatica can be caused by a disc bulge or herniation, lumbar canal stenosis, spondylolisthesis, trauma, piriformis syndrome, or spinal tumors. It affects women more than men and people who lead sedentary lifestyles more than active ones. It might arise quickly or gradually with physical activity, and it is usually unilateral.

The slider and tensioner are two distinct types of neural mobilization procedures. There are clinical improvements and positive therapeutic benefits after treatment with different neural mobilization techniques, but the slider technique is safer, involves less stretching and strain of the nerves, and has a more significant effect than the tensioner technique.

Conditions

Low Back Pain; Sciatica

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Study Group One

sciatic nerve slider technique in a slump lying position in combination with Conventional physiotherapy

Group Type: EXPERIMENTAL

sciatic nerve slider technique in slump lying position

Intervention Type: OTHER

The patient will be sitting at the edge of the couch with the posterior aspect of the knee at the edge, the thighs parallel to each other, and flexion at the thoracic and lumbar spines (slouch position). The therapist will be standing at the bedside of the patient with a proximal arm over the patient's shoulder and one hand guiding the neck movements of the patient and the other hand guiding the knee movements, passively performing cervical neck flexion with knee flexion (stretching the nerve proximally and relaxing at the distal end) and then moving into cervical extension with knee extension. Provide five sets in every session: the first: 10 repetitions, the second: 15 repetitions, the third: 20 repetitions, the fourth: 25 repetitions; and the fifth: 30 repetitions. The end position is held for 5 seconds, and the rest between sets is 1-2 minutes

Conventional physiotherapy

Intervention Type: OTHER

The patient will receive conventional physiotherapy, which includes: a moist hot pack, TENS, and back strengthening exercises (as a home program).

Study Group Two

sciatic nerve slider technique in a supine position in combination with Conventional physiotherapy

Group Type: EXPERIMENTAL

sciatic nerve slider technique in supine position

Intervention Type: OTHER

.The patient will be in a supine position. The therapist will hold the patient's limb passively and then move the hip into flexion with the ankle in plantar flexion and the knee in extension, stretching the nerve at the hip and relaxing at the ankle, Then reversing the movement with the hip into extension, maintaining the knee in extension and the ankle in dorsiflexion, relaxing the nerve at the hip and stretching at the ankle. Provide five sets in every session; the first: 10 repetitions, the second: 15 repetitions, the third: 20 repetitions, the fourth: 25 repetitions, and the fifth: 30 repetitions. The end position is held for 5 seconds, and the rest between sets is 1-2 minutes.

Conventional physiotherapy

Intervention Type: OTHER

The patient will receive conventional physiotherapy, which includes: a moist hot pack, TENS, and back strengthening exercises (as a home program).

Control Group

Conventional physiotherapy alone

Group Type: EXPERIMENTAL

Conventional physiotherapy

Intervention Type: OTHER

The patient will receive conventional physiotherapy, which includes: a moist hot pack, TENS, and back strengthening exercises (as a home program).

Interventions

sciatic nerve slider technique in slump lying position

The patient will be sitting at the edge of the couch with the posterior aspect of the knee at the edge, the thighs parallel to each other, and flexion at the thoracic and lumbar spines (slouch position). The therapist will be standing at the bedside of the patient with a proximal arm over the patient's shoulder and one hand guiding the neck movements of the patient and the other hand guiding the knee movements, passively performing cervical neck flexion with knee flexion (stretching the nerve proximally and relaxing at the distal end) and then moving into cervical extension with knee extension. Provide five sets in every session: the first: 10 repetitions, the second: 15 repetitions, the third: 20 repetitions, the fourth: 25 repetitions; and the fifth: 30 repetitions. The end position is held for 5 seconds, and the rest between sets is 1-2 minutes

Intervention Type: OTHER

sciatic nerve slider technique in supine position

.The patient will be in a supine position. The therapist will hold the patient's limb passively and then move the hip into flexion with the ankle in plantar flexion and the knee in extension, stretching the nerve at the hip and relaxing at the ankle, Then reversing the movement with the hip into extension, maintaining the knee in extension and the ankle in dorsiflexion, relaxing the nerve at the hip and stretching at the ankle. Provide five sets in every session; the first: 10 repetitions, the second: 15 repetitions, the third: 20 repetitions, the fourth: 25 repetitions, and the fifth: 30 repetitions. The end position is held for 5 seconds, and the rest between sets is 1-2 minutes.

Intervention Type: OTHER

Conventional physiotherapy

The patient will receive conventional physiotherapy, which includes: a moist hot pack, TENS, and back strengthening exercises (as a home program).

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age range between 40 - 65 years,
• Both genders,
• Diagnosed by magnetic resonance imaging to confirm disc lesion,
• LBP with radicular pain for more than 12 weeks up to 1 year with no acute episodes in the last 4 weeks, and a numeric pain rating score (NPRS) greater than 4/10.
• Positive SLR test with reproduction of neurological symptoms.

Exclusion Criteria

• Sciatica due to other pathologies (e.g. lumbar canal stenosis or piriformis syndrome),
• Having any physiotherapy before 6 months.
• History of spinal surgery
• Vertebral fracture or trauma,
• Negative SLR test,
• pregnant.

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

European University of Lefke

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Beliz Belgen Kaygisiz, PT, PhD

Role: PRINCIPAL_INVESTIGATOR

European University of Lefke

Locations

Princess Alia Governmental Hospital

Hebron, West Bank, Palestinian Territories

Countries

Palestinian Territories

Other Identifiers

BAYEK022.06

Identifier Type: -

Identifier Source: org_study_id