Effect of Hamstring Stretching and Neural Mobilization on Range of Motion and Low Back Pain
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.
|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)
|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)|
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
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.
|Contact: Michael L D'Agati, DPTemail@example.com|
|Contact: Susan L Edmond, DScfirstname.lastname@example.org|
|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 email@example.com|
|Contact: Anne McDonald, DPT 973 322 7529 firstname.lastname@example.org|
|Principal Investigator: Michael L D'Agati, DPT|
|Sub-Investigator: Susan L Edmond, DSc|