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NCT Number: NCT07646379

Effects of Spinal Mobilization With Leg Movement With and Without Neural Flossing Technique in Lumbar Radiculopathy

Lumbar radiculopathy is a spinal condition caused by compression or irritation of the lumbar nerve roots, leading to radiating leg pain, sensory changes, and functional disability. It commonly affects middle-aged and older adults, impairing daily activities and quality of life. Conservative treatments include medication, physiotherapy, and exercise. Spinal Mobilization with Leg Movement (SMWLM), a Mulligan technique, uses passive vertebral mobilization with active leg motion to reduce nerve compression and improve mobility. Neural flossing, or neurodynamic mobilization, enhances nerve mobility by promoting gliding of nerve roots, especially in cases of restricted neural movement. This study aims to evaluate the effects of spinal mobilization with leg movement (SMWLM) with and without neural flossing technique on pain, disability, and range of motion in patients with lumbar radiculopathy.

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Key information

Conditions

Lumbar Radiculopathy Nervous System Diseases Neurologic Manifestations Neuromuscular Diseases Pain Pathological Conditions, Signs and Symptoms Peripheral Nervous System Diseases Radiculopathy Signs and Symptoms

Age range

30 year–50 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

This single-blinded randomized clinical trial will be conducted at Noor Al-Shifa Hospital, Lahore, over 10 months following ethical approval. A total of 36 patients (18 in each group) with lumbar radiculopathy will be recruited by using non-probability convenience sampling. Group A will receive spinal mobilization with leg movement (SMWLM) with neural flossing technique, while Group B will receive spinal mobilization with leg movement (SMWLM) only. Each group will undergo treatment 3 times per week for 6 weeks, with each session lasting 45 minutes. Pre- and post-intervention assessments will include pain (NPRS), SLR range of motion (Goniometer), and disability (Modified Oswestry Disability Index). Data will be analyzed using SPSS version 26

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • • Patients aged between 30-50 years (9)
  • Both male and female genders
  • Patient should have lower back pain radiating to one side with numbness, tingling, and muscle weakness (12)
  • Positive Lasegue & slump test

Exclusion criteria

  • Any fracture or other injury
  • Any systemic illness
  • Any inflammatory disease (Rheumatoid arthritis, gout)
  • Disc herniation
  • Piriformis syndrome
  • Lumbar instability
  • Scoliosis

Treatment and study plan

SMWLM along with Neural flossing technique

Other

The participant will be positioned in side-lying with limb where the pain radiated to on top. Therapist 1 will stand at the participant's ventral side and apply transverse glide with the thumb on the involved lumbar spinous process. Therapist 2 will then abduct the affected leg by 10° and take the limb gently into hip flexion with knee extended, while the glide will be sustained continuously by therapist 1. The entire motion during mobilization will be maintained pain-free. The participant will be positioned in side-lying with limb where the pain radiated to on top. Therapist 1 will stand at the participant's ventral side and apply transverse glide with the thumb on the involved lumbar spinous process. Therapist 2 will then abduct the affected leg by 10° and take the limb gently into hip flexion with knee extended, while the glide will be sustained continuously by therapist 1. The entire motion during mobilization will be maintained pain-free.

SMWLM without Neural flossing technique

Other

The participant will be positioned in side-lying with limb where the pain radiated to on top. Therapist 1 will stand at the participant's ventral side and apply transverse glide with the thumb on the involved lumbar spinous process. Therapist 2 will then abduct the affected leg by 10° and take the limb gently into hip flexion with knee extended, while the glide will be sustained continuously by therapist 1. The entire motion during mobilization will be maintained pain-free. The procedure will be repeated three times as per Mulligans rule of 3, post which the SLR test and NPRS will be re-measured

Primary outcomes

  1. Numeric Pain Rating Scale for Pain

    Time frame: upto 4 weeks

    It is a widely used subjective measure for assessing pain intensity, where patients rate their pain on a scale from 0 (no pain) to 10 (worst imaginable pain). It has high test-retest reliability (ICC = 0.92) and strong construct validity for acute and chronic musculoskeletal conditions

  2. Goniometer for ROM

    Time frame: Upto 4 weeks

    It is a clinical instrument used to measure joint range of motion in degrees, commonly applied in musculoskeletal assessments. It demonstrates excellent intra-rater (ICC = 0.95) and inter-rater reliability (ICC = 0.89), with strong validity when compared with digital motion analysis tools

  3. Modfied Oswestry Disability Index for disability

    Time frame: Upto 4 weeks

    It is a self-reported questionnaire used to assess disability due to low back pain, covering aspects such as pain, mobility, and daily activities. It is a highly valid tool (construct validity r = 0.75) with excellent reliability (Cronbach's alpha = 0.90, ICC = 0.91), making it one of the most commonly used functional outcome measures in spine-related research

Study contacts

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

Samrood Akram, PhD*

CONTACT

[email protected]

03324806143

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Official study title

Effects of Spinal Mobilization With Leg Movement With and Without Neural Flossing Technique on Pain, Disability, and Range of Motion in Patients With Lumbar Radiculopathy

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jun 12, 2026
Registry last updated
Jun 12, 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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