Effect of Hamstring Stretching and Neural Mobilization on Range of Motion and Low Back Pain
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Purpose
The purpose of this study is to determine if, among patients with low back pain and a positive SLR, those who are identified as having a positive SLR due to neurological symptoms demonstrate greater improvements in range of motion and low back pain symptoms if treated with nerve mobilization techniques than those who are treated with muscle stretching techniques.
2. To determine if, among patients with low back pain and a positive SLR, those who are identified as having a positive SLR due to hamstring shortness demonstrate greater improvements in range of motion and low back pain symptoms if treated with muscle stretching techniques than those who are treated with nerve mobilization techniques.
| Condition | Intervention |
|---|---|
|
Low Back Pain |
Other: neural mobilization Other: straight leg raise |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Factorial Assignment Masking: Double Blind (Subject, Caregiver) Primary Purpose: Treatment |
- range of motion [ Time Frame: within 72 hours ] [ Designated as safety issue: No ]Measured with a bubble inclinometer
- changes in function [ Time Frame: Within 72 hours ] [ Designated as safety issue: No ]Measured with the Modified Oswestry Disability Index
- Pain [ Time Frame: Within 72 hours ] [ Designated as safety issue: No ]Numeric Pain Rating Scale (11 points, 0-10)
| Estimated Enrollment: | 50 |
| Study Start Date: | May 2010 |
| Estimated Study Completion Date: | May 2012 |
| Estimated Primary Completion Date: | May 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: straight leg raise
stretch the muscle
|
Other: straight leg raise
stretch the hamstring
Other Name: hamstring stretching
|
|
Experimental: neural mobilization
stretch the nerve
|
Other: neural mobilization
stretch the nerve
|
Detailed Description:
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.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
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
Contacts and Locations| Contact: Michael L D'Agati, DPT | dagatiml@umdnj.edu | |
| Contact: Susan L Edmond, DSc | 973-972-9732 | edmondsl@umdnj.edu |
| United States, New Jersey | |
| Barnabas Health Ambulatory Care Center | Recruiting |
| Livingston, New Jersey, United States, 07039 | |
| Contact: Michael L D'Agati, DPT 973-322-7536 mdagati@sbhcs.com | |
| Contact: Anne McDonald, DPT 973 322 7529 agiblin@sbhcs.com | |
| Principal Investigator: Michael L D'Agati, DPT | |
| Sub-Investigator: Susan L Edmond, DSc | |
More Information
Publications:
| Responsible Party: | University of Medicine and Dentistry New Jersey |
| ClinicalTrials.gov Identifier: | NCT01483573 History of Changes |
| Other Study ID Numbers: | 0120100079 |
| Study First Received: | October 7, 2010 |
| Last Updated: | November 30, 2011 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of Medicine and Dentistry New Jersey:
|
low back pain straight leg raise |
Additional relevant MeSH terms:
|
Back Pain Low Back Pain Pain |
Neurologic Manifestations Nervous System Diseases Signs and Symptoms |
ClinicalTrials.gov processed this record on May 23, 2013