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NCT Number: NCT07304765

Acute Effects of Neurodynamic Stretching on Muscle-tendon Complex

Neurodynamic mobilization techniques are widely applied in rehabilitation and physiotherapy to enhance the mobility and function of peripheral nerves. Two main approaches are distinguished. Nerve tensioning and nerve flossing. They both involve proximal and distal joint movements to induce greater neural sliding while avoiding excessive tensile stress. However, contradictory findings on neurodynamic techniques highlighted the current lack of consensus regarding these techniques. Moreover, neurodynamic techniques are of interest for patients, it appeared it could also be applied in healthy individuals and more particularly in athletes. Accordingly, the primary objective of the present study was to determine the immediate effect of two neurodynamic mobilization techniques (flossing vs. tensioning) on the sciatic nerve and hamstring tissues using the shear wave elastography (SWE, a form of ultrasonography).

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Key information

Conditions

Stretching Control Condition

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Universite Bourgogne Europe - faculty of sports sciences

Dijon, France

About this study

Neurodynamic mobilization techniques are frequently applied in rehabilitation settings to enhance the mobility and function of peripheral nerves, particularly in the management of neuropathic pain such as carpal tunnel syndrome, radiculopathies, or sciatica. Two main approaches are distinguished. Nerve tensioning involves maintaining the nerve stretched at the end of the joint range of motion with relatively limited excursion. It is similar to a static stretching intervention but with distal (ankle) and proximal (cervical) tensions. Nerve flossing (also termed gliding or sliders), consists of alternating proximal and distal joint movements to induce greater neural sliding while avoiding excessive tensile stress. However, contradictory findings on neurodynamic techniques highlighted the current lack of consensus regarding the acute effects of the different possible neurodynamic techniques on sciatic nerves, particularly in healthy tissues. Moreover, neurodynamic techniques are of interest for patients, it appeared it could also be applied in healthy individuals and more particularly in athletes. Performed in patients, healthy or athletes, no study has compared both tensioning or flossing techniques. Moreover, because these techniques involved nerve mobilisation, the intensity should have a main effect of its efficiency. Accordingly, the primary objective of the present study was to determine the immediate effect of two neurodynamic mobilization techniques (flossing vs. tensioning) on the sciatic nerve and hamstring tissues using the shear wave elastography (SWE). This method has been shown reliable to provide non-invasive real-time assessments of soft tissues elastic properties. The secondary aim was to determine the effects of stretching intensity (at the point of pain threshold or below).

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • healthy
  • physical active
  • no injuries (lower limb or back pain) in the past 3 months

Exclusion criteria

  • Specific lower limb (hamstring) injuries in the past 2 years
  • Not restraining activity 24h before participation

Treatment and study plan

Maximal static stretching

Other

Static stretching was applied at pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. Static stretching mainly focused muscle-tendon tissues.

Submaximal static stretching

Other

Static stretching was applied 10% below pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. Static stretching mainly focused muscle-tendon tissues.

Maximal neurodynamic tensioning

Other

Neurodynamic tensioning was applied at pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. During the neurodynamic conditions, head and ankle movement permitted to mobilize nerve tissues. Tensioning is maintaining the position.

Submaximal neurodynamic tensioning

Other

Neurodynamic tensioning was applied 10% below pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. During the neurodynamic conditions, head and ankle movement permitted to mobilize nerve tissues. Tensioning is maintaining the position.

Maximal neurodynamic flossing

Other

Neurodynamic flossing was applied at pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. During the neurodynamic conditions, head and ankle movement permitted to mobilize nerve tissues. Flossing is the alternation of these movements every 2 seconds.

Submaximal neurodynamic flossing

Other

Neurodynamic flossing was applied 10% below pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. During the neurodynamic conditions, head and ankle movement permitted to mobilize nerve tissues. Flossing is the alternation of these movements every 2 seconds.

Primary outcomes

  1. Nerve shear wave velocity using elastography

    Time frame: Before the intervention and at the end (immediately after) the intervention

    Shear wave velocity of the sciatic nerve will be evaluated by using an ultrasound (echography) device with a specific mode called "shear wave elastography". Briefly, the ultrasound probe will deliver an ultrasound wave. The propagation speed (called '"shear wave velocity") will be measured by the same probe. The greater the velocity is, the harder the tissue is.

Secondary outcomes

  1. Muscle shear wave velocity using elastography

    Time frame: Before the intervention and at the end (immediately after) the intervention

    Shear wave velocity of the biceps femoris muscle will be evaluated by using an ultrasound (echography) device with a specific mode called "shear wave elastography". Briefly, the ultrasound probe will deliver an ultrasound wave. The propagation speed (called '"shear wave velocity") will be measured by the same probe. The greater the velocity is, the harder the tissue is.

  2. Hamstring force

    Time frame: Before the intervention and at the end (immediately after) the intervention

    Maximal torque during a maximal voluntary hamstring contraction

  3. Biceps femoris activity

    Time frame: Before the intervention and at the end (immediately after) the intervention

    Electromyographic activity of biceps femoris muscle

  4. Semitendinosus activity

    Time frame: Before the intervention and at the end (immediately after) the intervention

    Electromyographic activity of semitendinosus

  5. passive knee extension

    Time frame: Before the intervention and at the end (immediately after) the intervention

    The final passive range of motion of the hamstring muscles

  6. Global flexibility

    Time frame: Before the intervention and at the end (immediately after) the intervention

    the stand and reach test to evaluate flexibility (in centimeters)

  7. Slump test

    Time frame: Before the intervention and at the end (immediately after) the intervention

    Seated flexibility using the slump test (in degrees)

  8. discomfort

    Time frame: At the end (immediately after) the intervention

    rating of perceived discomfort during the intervention (from 1 to 10, no discomfort to maximal discomfort, respectively)

Sponsors and collaborators

Lead sponsor

University of Burgundy

Other

Registry information

Official study title

The Acute Effects of Neurodynamic Stretching the Shear Wave Velocity: on Application on Muscle and Nerve Tissues

Acronym: ELASTRETCH

Important dates

Study start
2023
Primary completion
2024
Study completion
2024
First posted
Dec 26, 2025
Registry last updated
Dec 26, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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