Effect of Neurodynamic Moblization Versus Mulligan on Pain and Functional Abilities in Patients With Chronic Discogenic Sciatica

NCT ID: NCT07050108

Last Updated: 2025-07-03

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 66 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-06-30
• Study Completion Date: 2025-08-01

Brief Summary

The purpose of the present study to compare between the effect of neurodynamic moblizaton and Mulligan SNAG's moblization on patients with chronic unilateral discogenic sciatica.

Detailed Description

Sciatica is a common problem in patients suffer from lumbar disc prolapse with an incidence of five cases per 1000 adults in developed countries . Sciatica causes significant disability. When applying neurodynamics, tension occurs in the nervous system, and pressure within the nerve increases due to the decrease of the cross-sectional area, and the axonal transport system lengthens the sciatic nerve after shortening because of the influence of the surrounding related structures and hamstring flexibility . After extention of the nerve and muscle, muscle performance is improved because of increases in the number of muscle fiber segments and cross-sectional area of muscle fibers.The majority of the research concerned with SNAG techniques has concentrated on the study of peripheral joints and the cervical region. Few studies have been concerned with the effects of SNAG on the lumbar spine. The rest of the available research was in the form of case reports or case series. Only 5 trials have investigated different effects of the SNAG technique when applied to the lumbar region. This study will improve the conservative treatment for sciatica and will decrease the cost of treatment and disability of the patient.

Conditions

Sciatica; Discogenic Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

neurodynamic mobilization

twenty two patients will receive neurodynamic mobilization and selected physical therapy program three times a week for four weeks

Group Type: EXPERIMENTAL

neurodynamic mobilization

Intervention Type: OTHER

the patients will receive neurodynamic mobilization in the form of opening technique which include; static opening and dynamic opening. also, sliding and tensioning technique+ selected physical therapy program

selected physical therapy program

Intervention Type: OTHER

The program of therapeutic exercises consisted of upper and lower back exercises. Each exercise will repeat from ten to thirty times, three repetitions in three sets with rest one to two minutes between the sets. The repetition of each exercise vary according to the physical ability of each patient.

Lower back strengthening exercises: From prone lying position, the patient will asked to raise one lower limb then the other then both lower limbs+ TENS and US

Mulligan therapy

twenty two patients will receive mulligan therapy and selected physical therapy program three times a week for four weeks

Group Type: EXPERIMENTAL

mulligan therapy

Intervention Type: OTHER

sustained natural apophyseal glide SNAGs are mobilisation techniques and are used as part of the Mulligan Concept+ selected physical therapy program The patient position is stitting on the edage of the plenth non weight bearing position. The therapist will stand behind the patient, the therapist will apply SNAG for 3 repetitions during the initial screening session,the patient will be asked to lean forwared while applying the technique .the therapist apply onle from fove to seven repetitions.patients who experienced no worsening or showed improvement of pain and ROM were considered good indication for the effectivness of treatment .

selected physical therapy program

Intervention Type: OTHER

The program of therapeutic exercises consisted of upper and lower back exercises. Each exercise will repeat from ten to thirty times, three repetitions in three sets with rest one to two minutes between the sets. The repetition of each exercise vary according to the physical ability of each patient.

Lower back strengthening exercises: From prone lying position, the patient will asked to raise one lower limb then the other then both lower limbs+ TENS and US

selected physical therapy program

twenty two patients will selected physical therapy program three times a week for four weeks

Group Type: ACTIVE_COMPARATOR

selected physical therapy program

Intervention Type: OTHER

The program of therapeutic exercises consisted of upper and lower back exercises. Each exercise will repeat from ten to thirty times, three repetitions in three sets with rest one to two minutes between the sets. The repetition of each exercise vary according to the physical ability of each patient.

Lower back strengthening exercises: From prone lying position, the patient will asked to raise one lower limb then the other then both lower limbs+ TENS and US

Interventions

neurodynamic mobilization

the patients will receive neurodynamic mobilization in the form of opening technique which include; static opening and dynamic opening. also, sliding and tensioning technique+ selected physical therapy program

Intervention Type: OTHER

mulligan therapy

sustained natural apophyseal glide SNAGs are mobilisation techniques and are used as part of the Mulligan Concept+ selected physical therapy program The patient position is stitting on the edage of the plenth non weight bearing position. The therapist will stand behind the patient, the therapist will apply SNAG for 3 repetitions during the initial screening session,the patient will be asked to lean forwared while applying the technique .the therapist apply onle from fove to seven repetitions.patients who experienced no worsening or showed improvement of pain and ROM were considered good indication for the effectivness of treatment .

Intervention Type: OTHER

selected physical therapy program

The program of therapeutic exercises consisted of upper and lower back exercises. Each exercise will repeat from ten to thirty times, three repetitions in three sets with rest one to two minutes between the sets. The repetition of each exercise vary according to the physical ability of each patient.

Lower back strengthening exercises: From prone lying position, the patient will asked to raise one lower limb then the other then both lower limbs+ TENS and US

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• All the patients diagnosed as lumbar radiculopathy (L5-S1) for at least six months. Diagnosis was confirmed by physical, neurological examination (motor assessment, sensory assessment, reflexes) and radiological assessment (CT or MRI).
• All patients has second grade of disc bulge which will detect from T2 axial view of MRI according to Fardon and Milette
• All patients has unilateral radiculopathy and pain in the distribution of scaitic nerve.
• The age of the patients will range from 35 to 50years . Their body mass index will range between( 22-25)

Exclusion Criteria

• Bilateral and multilevel disc prolapse or bilateral radtadiating pain
• acute pain (pain less than three months).
• Presence of active infection in lumbar spine.
• Any other spinal deformities.
• Postoperative cases.
• Cauda equine lesion.
• Neoplasmic.
• Spinal stenosis.
• Mechanical low back pain.
• Failed back syndrome.

• Minimum Eligible Age: 35 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Asmaa ibrahim attia

principle investigator : Asmaa ibrahim Attia

Responsibility Role: PRINCIPAL_INVESTIGATOR

Central Contacts

asmaa attia, master

Role: CONTACT

asmaa.ibrahim@su.edu.eg

0 11 55179241

Other Identifiers

P.T.REC/012/004903

Identifier Type: -

Identifier Source: org_study_id