Effect of Neurodynamic Mobilization in Patients With Lumbar Disc Herniation

NCT ID: NCT07203560

Last Updated: 2025-10-02

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-06-04
• Study Completion Date: 2019-05-10

Brief Summary

The objective of this randomized controlled trial was to investigate the effects of neurodynamic mobilization on pain intensity, normal joint motion, neurodynamics, functional level, and disability in patients with lumbar disc herniation.

Detailed Description

Background: Low back pain is a major cause of disability worldwide, and due to the limited effectiveness of current treatments, this study aimed to evaluate the efficacy of neurodynamic mobilization technique on pain intensity, range of motion, neurodynamics, functional status, and disability in patients.

Methods: Thirty-seven patients were randomized to control or mobilization group. Participants in the control group received a conventional therapy for 20 treatment sessions, and those in the mobilization group were treated neurodynamic mobilization in addition to the electro/thermal therapy program twice a week for 4 consecutive weeks. Pain level at rest and during activity was recorded with a Visual Analog Scale. Active lumbar flexion, extension, and lateral flexion were measured with a universal goniometer. Neurodynamic mobility was evaluated using neurodynamic tests. The functional status was assessed with the 30-second chair stand test and disability was evaluated with the Bournemouth Questionnaire. 2x2 repeated measures ANOVA models were used to determine within and between group differences.

Conditions

Lumbar Disc Herniation; Low Back Pain

Study Design

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

Study Groups

Neurodynamic Mobilization + Conventional Therapy (Experimental Group)

Participants received the conventional physiotherapy program plus neurodynamic mobilization administered by a physical therapist. Treatment was given 5 days a week for 4 weeks, for a total of 20 sessions.

Group Type: EXPERIMENTAL

Neurodynamic Mobilization

Intervention Type: OTHER

In the experimental group, neurodynamic mobilization was applied in addition to the conventional physiotherapy program. For the neurodynamic mobilization tibial nerve neural mobilization was performed. For neural mobilization of the tibial nerve, the patient was placed in the side-lying position with the hip in 90° flexion, knee flexion and ankle dorsi flexion. In this position, the ankle and hip positions were maintained, and knee extension was performed. When the symptoms were at a level that would not disturb the patient, it was held for 5 seconds, and knee flexion was performed by plantar flexion of the ankle. This practice was performed twice a week with 10 repetitions by a physiotherapist. The same neurodynamic mobilization exercise was recommended to the patients in the neuromobilization group as a home program with 10 repetitions twice a day.

Conventional Physiotherapy

Intervention Type: OTHER

All participants received hot pack therapy (20 minutes), conventional TENS (60 Hz, 60 msec, 20 minutes), therapeutic ultrasound (1.5 W/cm², 10 minutes), and a prescribed home exercise program, delivered 5 days per week for 4 weeks (20 sessions in total).

Conventional Therapy (Control Group)

Individuals in control group received hot therapy (Hotpack, 20 minutes), Conventional Tens (60 Hz, 60 msec, 20 minutes) and Therapeutic Ultrasound (1.5 w/cm2, 10 minutes). Patients were given an exercise program to do at home and the treatment was given 5 days a week for 4 weeks, for a total of 20 sessions, to all patients in the study.

Group Type: ACTIVE_COMPARATOR

Conventional Physiotherapy

Intervention Type: OTHER

All participants received hot pack therapy (20 minutes), conventional TENS (60 Hz, 60 msec, 20 minutes), therapeutic ultrasound (1.5 W/cm², 10 minutes), and a prescribed home exercise program, delivered 5 days per week for 4 weeks (20 sessions in total).

Interventions

Neurodynamic Mobilization

In the experimental group, neurodynamic mobilization was applied in addition to the conventional physiotherapy program. For the neurodynamic mobilization tibial nerve neural mobilization was performed. For neural mobilization of the tibial nerve, the patient was placed in the side-lying position with the hip in 90° flexion, knee flexion and ankle dorsi flexion. In this position, the ankle and hip positions were maintained, and knee extension was performed. When the symptoms were at a level that would not disturb the patient, it was held for 5 seconds, and knee flexion was performed by plantar flexion of the ankle. This practice was performed twice a week with 10 repetitions by a physiotherapist. The same neurodynamic mobilization exercise was recommended to the patients in the neuromobilization group as a home program with 10 repetitions twice a day.

Intervention Type: OTHER

Conventional Physiotherapy

All participants received hot pack therapy (20 minutes), conventional TENS (60 Hz, 60 msec, 20 minutes), therapeutic ultrasound (1.5 W/cm², 10 minutes), and a prescribed home exercise program, delivered 5 days per week for 4 weeks (20 sessions in total).

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age between 20 and 60 years
• Diagnosed with lumbar disc herniation at one or more of the L3-L4, L4-L5
• L5-S1 levels with prolapsed, protruding, or extruding disc confirmed by MRI
• Presence of low back pain for at least 6 weeks.

Exclusion Criteria

• Spinal stenosis
• Previous lumbar surgery or medical treatment for disc herniation
• Pregnancy
• Severe osteoporosis
• Diabetes mellitus
• Severe neurological deficit

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Aydin Adnan Menderes University

OTHER

Sponsor Role: lead

Responsible Party

Gurkan Gunaydin

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Gurkan Gunaydin

Role: PRINCIPAL_INVESTIGATOR

Aydin Adnan Menderes University

Locations

Gazi University Department of Physical Therapy and Rehabilitation

Ankara, Çankaya, Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

ADU-FTR-GG-01

Identifier Type: -

Identifier Source: org_study_id