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NCT Number: NCT07726823

Comparative Effects of Mulligan Bent Leg Raise Versus Spinal Mobilization With Leg Movement in Lumbar Radiculopathy

Lumbar radiculopathy is a spinal nerve root disorder often caused by lumbar disc herniation or compression, leading to radiating leg pain, restricted movement, and functional difficulties. This condition significantly disrupts daily activities and overall quality of life. While medication and exercise are common treatments, manual therapy techniques are gaining recognition for their non-invasive and effective outcomes in relieving symptoms and improving patient function.

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Key information

Conditions

Lumbar Radiculopathy Nervous System Diseases Neuromuscular Diseases Peripheral Nervous System Diseases Radiculopathy

Age range

20 year–40 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Femwell Physiocare Woman Rehab clinic

Lahore, Punjab Province, 54000, Pakistan

Location status: Recruiting

Location contact

Arooj Fatima, MS-OMPT

CONTACT

[email protected]

03270056769

About this study

This randomized clinical trial will be conducted in Physiotherapy outpatient department of Jinnah Hospital Lahore. It will include 52 participants, aged 20 to 40 years, meeting clinical criteria for lumbar radiculopathy. Participants will be selected from an outpatient physiotherapy department and assigned randomly into two equal groups. Group A will receive the MBLR technique, while Group B will undergo the SMWLM technique. Both interventions will be applied three times a week for four weeks under standardized protocols. Key outcome measures include pain intensity assessed using the Numeric Pain Rating Scale (NPRS), neural mobility evaluated through the Straight Leg Raise (SLR) and Slump Test, and functional status measured using the Oswestry Disability Index (ODI), Timed Up and Go (TUG) test, and 5 Repetition Sit-to-Stand test for postural balance. Assessments will be conducted at baseline, after 2 weeks, at 4 weeks post-intervention, and at 8-week follow-up. Data analysis will be done by SPSS version 25. To ensure objectivity, all assessments will be conducted while keeping the patient unaware of their group assignment.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age 20 to 40 years (26)
  • Diagnosed patient with Unilateral Lumbar Radiculopathy secondary to L4/L5 and L5/S1 lumbar posterolateral disc buldge confirmed on MRI (12)
  • Posterolateral Lumbar Radiculopathy

Exclusion criteria

  • • Presence of red flags (e.g., cauda equina syndrome, severe neurological deficits).
  • Previous spinal surgery within 1 year.
  • Severe osteoporosis or vertebral fractures.
  • Pregnant women.
  • Systemic inflammatory or autoimmune diseases.

Treatment and study plan

Mulligan Bent Leg Raise (MBLR)

Other

Patient Position - Supine at edge of plinth

  • Affected hip and knee flexed to 90°
  • Hand of affected side under head and neck Therapist Position - Stands in walk stance, lateral to affected limb Therapist Hand Placement - Inner shoulder under popliteal fossa
  • Both hands grasp lower thigh Mobilization Procedure - Apply longitudinal traction along femur
  • Flex hip toward same side shoulder until first resistance
  • Patient performs isometric hold (5 sec)
  • On relaxation, increase hip flexion if pain free
  • Hold new position ~20 sec
  • Repeat 3 times if tolerated Precautions - Maintain knee flexion
  • No need to stabilize opposite leg

Spinal Mobilization With Leg Movement (SMWLM)

Other

Patient Position - Side-lying on unaffected side near edge

  • Affected leg on top, supported by assistant
  • Hip abducted ~10°, extended; knee flexed ~45° Therapist Position - Primary therapist behind pelvis
  • Assistant supports upper leg during movement Therapist Hand Placement - Supported thumb on spinous process of affected vertebra
  • Gentle transverse pressure maintained throughout movement Mobilization Procedure - Assistant helps patient actively lift leg (SLR)
  • Movement within pain free range
  • If symptoms appear, hold for ~3 sec then return
  • Start with 3 reps; increase to 6 with light overpressure as tolerated Precautions - Stay within non painful range
  • Maintain steady, controlled transverse pressure
  • Avoid excessive force, especially early on

Primary outcomes

  1. NPRS for pain

    Time frame: upto 4 weeks

    Pain intensity will be evaluated using the Numeric Pain Rating Scale, which ranges from 0 indicating "no pain" to 10 representing the "worst possible pain." It has shown excellent test-retest reliability, with intraclass correlation coefficients (ICC) ranging between 0.95 and 0.98 in individuals with musculoskeletal conditions

  2. SLR and Slump test for neural mobility

    Time frame: Upto 4 weeks

    To assess neural mobility, the Straight Leg Raise and Slump Tests will be employed. These are well-established clinical tools for identifying lumbar nerve root irritation. The SLR test demonstrates strong diagnostic accuracy (~81%) and excellent inter-rater reliability with kappa values above 0.90 and aprox 0.71 for slump test

  3. Oswestry Disability Index test for functional outcome

    Time frame: Upto 4 weeks

    The ODI will be used to determine the level of functional disability associated with lower back pain. It includes 10 items that assess various aspects of daily activity. The tool has proven to be highly reliable (Cronbach's alpha = 0.87) and valid across different patient populations with lumbar spine conditions

  4. Time up and go (TUG) test for functional outcome

    Time frame: Upto 4 weeks

    Balance and functional mobility will be measured using the TUG test, which involves timing a patient as they rise from a chair, walk three meters, turn, return, and sit down. This test is highly reliable (ICC = 0.82 to 0.99) and shows good concurrent validity in both spinal and geriatric populations (34). The cutoff value for balance and functional mobility TUG test is 7.2 sec

  5. Five repetition sit to stand test

    Time frame: upto 4 weeks

    The 5 Rep Sit-to-Stand Test will be used to assess lower limb strength and functional performance. The patient gets to their maximum standing position and then sits back down five times as fast as they can without the use of their hands or arms. It has demonstrated excellent reliability (ICC > 0.90) and shows strong correlation with functional ability (36). The cutoff value is > 10 sec for 5 rep sitting to standing and standing to sitting transition

Study contacts

Contact information is provided by the study sponsor or research team.

Amna Zia, PhD*

CONTACT

[email protected]

03244686993

Samrood Akram, PhD*

CONTACT

[email protected]

03324806143

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Official study title

Comparative Effects of Mulligan Bent Leg Raise Versus Spinal Mobilization With Leg Movement on Pain, Neural Mobility, Balance and Functional Disability in Lumbar Radiculopathy

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jul 24, 2026
Registry last updated
Jul 24, 2026

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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