Effect of Hamstring Stretching and Neural Mobilization on Range of Motion and Low Back Pain



Status:Terminated
Conditions:Back Pain
Therapuetic Areas:Musculoskeletal
Healthy:No
Age Range:18 - 65
Updated:4/21/2016
Start Date:May 2010
End Date:July 2015

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This study was designed to answer 3 primary research questions:

1. In adults with low back pain, reduced SLR ROM (Range of Motion) and a positive
sensitized SLR (Straight leg raise) test, does neurodynamic mobilization result in
greater SLR ROM, pain reduction and perceived improvement than muscle stretching?

2. In adults with low back pain, reduced SLR ROM and a negative sensitized SLR test, does
muscle stretching result in greater SLR ROM, pain reduction and perceived improvement
than neurodynamic mobilization?

3. In adults with low back and reduced SLR, does neurodynamic mobilization or muscle
stretching result in greater SLR ROM, pain reduction and perceived improvement
irrespective of the outcome of SLR sensitization?

The research hypotheses are threefold:

1. Subjects determined to have nerve-related pain and ROM restrictions by a positive
sensitized SLR test would benefit more from neurodynamic mobilization than muscle
stretching.

2. Subjects determined to have muscle-related pain and ROM restrictions by a negative
sensitized SLR test would benefit more from muscle stretching than neurodynamic
mobilization.

3. Subjects would benefit the same from muscle stretching and neurodynamic mobilization
when not matched on the outcome of the SLR sensitization.

Potential subjects will sign an informed consent and be evaluated for inclusion in the
study. Subjects meeting the inclusion criteria will be asked to complete a form asking
questions regarding their demographics, pain history and symptomatology. The form will also
include a numeric pain rating scale to determine pain severity, and a standardized
questionnaire commonly used in back pain research (i.e., the Modified Oswestry Disability
Index). Subjects will then be evaluated for SLR range of motion on the side with the least
amount of SLR range of motion using a bubble inclinometer.

Subjects will then be randomly assigned to receive a treatment to address hamstring length
or a treatment to address sciatic nerve restrictions. A second researcher who is blinded to
the results of the data obtained pre-treatment will administer the treatment. Hamstring
stretching will consist of positioning the subject's hip in flexion and knee in extension,
and holding this position for 30 seconds. This treatment will be repeated 5 times. Nerve
mobilization will consist of either momentarily positioning the hip in flexion, the knee in
extension and the ankle in dorsiflexion, and then moving the ankle in and out of
dorsiflexion at a rate of about 1 - 2 movements per second (theoretically, this should
stretch the nerve), or moving the lower leg such that it is first positioned into hip
extension and ankle dorsiflexion, and then into hip flexion and ankle plantarflexion
(theoretically, this should glide the nerve in its sheath). The choice of technique will be
made by the treating therapist. Both treatments should take approximately 4 minutes to
complete.

Following this intervention, subjects will be re-evaluated for SLR range of motion using a
bubble inclinometer by the same researcher who collected the pre-treatment data. During the
next visit to physical therapy, this researcher will re-evaluate subjects SLR range of
motion, as previously described; and pain, by the numeric pain rating scale.

Inclusion Criteria:

- Patients referred to physical therapy for low back pain with limitations in hamstring
range of motion on the painful side

Exclusion Criteria:

- Red flags
We found this trial at
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(212) 263-7300
New York University Langone Medical Center NYU NYU Langone Medical Center, a world-class, patient-centered, integrated,...
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