Gustavo Plaza-Manzano1, Ignacio Cancela-Cilleruelo, César Fernández-de-Las-Peñas, Joshua A Cleland, José L Arias-Buría, Marloes Thoomes-de-Graaf, Ricardo Ortega-Santiago. 1. From the Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain (GP-M); Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain (GP-M); Clínica Fisiofit, Madrid, Spain (IC-C); Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain (CF-d-l-P, JLA-B, RO-S); Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapeútico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain (CF-d-l-P, JLA-B, RO-S); Physical Therapist, Rehabilitation Services, Concord Hospital, Concord, New Hampshire (JAC); Faculty, Manual Therapy Fellowship Program, Regis University, Denver, Colorado (JAC); Department of Physical Therapy, Franklin Pierce University, Manchester, New Hampshire (JAC); and Fysio-Experts, Hazerswoude-Rijndijk, the Netherlands (MT-d-G).
Abstract
OBJECTIVE: The aim of the study was to investigate the effects of the inclusion of neural mobilization into a motor control exercise program on pain, related disability, neuropathic symptoms, straight leg raise, and pressure pain thresholdin lumbar radiculopathy. DESIGN: This is a randomized clinical trial. METHODS:Individuals with low back pain, with confirmed disc herniation, and lumbar radiculopathy were randomly assigned to receive eight sessions of either neurodynamic mobilization plus motor control exercises (n = 16) or motor control exercises alone (n = 16). Outcomes included pain, disability, neuropathic symptoms, straight leg raise, and pressure pain threshold at baseline, after four visits, after eight visits, and after 2 mos. RESULTS: There were no between-groups differences for pain, related disability, or pressure pain threshold at any follow-up period because both groups get similar and large improvements. Patients assigned to the neurodynamic program group experienced better improvements in neuropathic symptoms and the straight leg raise compared with the motor control exercise group (P < 0.01). CONCLUSIONS: The addition of neurodynamic mobilization to a motor control exercise program leads to reductions in neuropathic symptoms and mechanical sensitivity (straight leg raise) but did not result in greater changes of pain, related disability, or pressure pain threshold over motor control exercises program alone in subjects with lumbar radiculopathy. Future trials are needed to further confirm these findings because between-groups differences did not reach clinically relevance.
RCT Entities:
OBJECTIVE: The aim of the study was to investigate the effects of the inclusion of neural mobilization into a motor control exercise program on pain, related disability, neuropathic symptoms, straight leg raise, and pressure pain threshold in lumbar radiculopathy. DESIGN: This is a randomized clinical trial. METHODS: Individuals with low back pain, with confirmed disc herniation, and lumbar radiculopathy were randomly assigned to receive eight sessions of either neurodynamic mobilization plus motor control exercises (n = 16) or motor control exercises alone (n = 16). Outcomes included pain, disability, neuropathic symptoms, straight leg raise, and pressure pain threshold at baseline, after four visits, after eight visits, and after 2 mos. RESULTS: There were no between-groups differences for pain, related disability, or pressure pain threshold at any follow-up period because both groups get similar and large improvements. Patients assigned to the neurodynamic program group experienced better improvements in neuropathic symptoms and the straight leg raise compared with the motor control exercise group (P < 0.01). CONCLUSIONS: The addition of neurodynamic mobilization to a motor control exercise program leads to reductions in neuropathic symptoms and mechanical sensitivity (straight leg raise) but did not result in greater changes of pain, related disability, or pressure pain threshold over motor control exercises program alone in subjects with lumbar radiculopathy. Future trials are needed to further confirm these findings because between-groups differences did not reach clinically relevance.