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NCT Number: NCT07203560

Effect of Neurodynamic Mobilization in Patients With Lumbar Disc Herniation

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.

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Key information

Conditions

Lumbar Disc Herniation Back Pain Bone Diseases Hernia Intervertebral Disc Displacement Low Back Pain Mononeuropathies Musculoskeletal Diseases Nervous System Diseases Neuralgia Neurologic Manifestations Neuromuscular Diseases Pain Pathological Conditions, Anatomical Pathological Conditions, Signs and Symptoms Peripheral Nervous System Diseases Sciatic Neuropathy Sciatica Signs and Symptoms Spinal Diseases

Age range

20 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Gazi University Department of Physical Therapy and Rehabilitation

Ankara, Çankaya, 06690, Turkey (Türkiye)

About this study

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.

Who can participate

Healthy volunteers accepted: No

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

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

Treatment and study plan

Neurodynamic mobilization

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

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).

Primary outcomes

  1. Pain Intensity

    Time frame: Pain was assessed at baseline (before treatment) and at the end of 4 weeks of treatment (post-treatment)

    Patients' rest and activity pain levels was assessed via a visual analog scale (VAS). Participants were asked to mark the intensity of pain they felt on a 10-centimeter (cm) horizontal line (0 indicates no pain, 10 indicates intolerable pain). The point marked on the line was measured with a ruler and the VAS value was recorded in cm

Secondary outcomes

  1. ROM

    Time frame: Rom was assessed at baseline (before treatment) and at the end of 4 weeks of treatment (post-treatment).

    Rom of the lumbar region was evaluated using a universal goniometer. Lumbar flexion and extension, right and left lateral trunk flexion were measured actively and recorded in terms of degree.

  2. Neurodynamic Mobility - Slump Test

    Time frame: These were assessed at baseline (before treatment) and at the end of 4 weeks of treatment (post-treatment).

    Slump test The patient was asked to sit on the edge of the examination table with the knee flexed at 90° and to flex the neck, back, and lower back respectively. He was then asked to bring his big toe towards his head by extending the knee. In this position, the angle between the starting position and the fibula was measured with a universal goniometer. The test was repeated twice and the mean degree was recorded.

  3. Neurodynamic Mobility - Sit and Reach Test

    Time frame: Baseline (before treatment) and at the end of 4 weeks of treatment (post-treatment)

    Sit and Reach test The top of a table with a height of 32 cm and a length of 35 cm was scaled by dividing it into cm. The patient was asked to sit on the floor and rest the sole of her bare foot flat on the test table. She was then instructed to reach as far as possible forward on the table without bending her knees from her trunk. The extreme point at which her fingers extended was measured in cm. In this way, at the farthest point, they waited 1-2 seconds without stretching forward or backward. The test was repeated twice, and the mean was recorded in cm

Sponsors and collaborators

Lead sponsor

Aydin Adnan Menderes University

Other

Registry information

Official study title

Neurodynamic Mobilization for the Management of Patients With Lumbar Disc Herniation: A Randomized Controlled Study

Important dates

Study start
2018
Primary completion
2019
Study completion
2019
First posted
Oct 2, 2025
Registry last updated
Oct 2, 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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