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

This study is currently recruiting participants. (see Contacts and Locations)
Verified May 2013 by Rutgers, The State University of New Jersey
Sponsor:
Information provided by (Responsible Party):
Rutgers, The State University of New Jersey ( University of Medicine and Dentistry of New Jersey )
ClinicalTrials.gov Identifier:
NCT01483573
First received: October 7, 2010
Last updated: February 11, 2014
Last verified: May 2013

October 7, 2010
February 11, 2014
May 2010
December 2014   (final data collection date for primary outcome measure)
range of motion [ Time Frame: within 72 hours ] [ Designated as safety issue: No ]
Measured with a bubble inclinometer
Same as current
Complete list of historical versions of study NCT01483573 on ClinicalTrials.gov Archive Site
Not Provided
Not Provided
Not Provided
Not Provided
 
Effect of Hamstring Stretching and Neural Mobilization on Range of Motion and Low Back Pain
Effect of Hamstring Stretching and Neural Mobilization on Range of Motion and Low Back Pain

This study was designed to answer 3 primary research questions:

  1. In adults with low back pain, reduced SLR ROM and a positive sensitized SLR 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.

Interventional
Not Provided
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Factorial Assignment
Masking: Double Blind (Subject, Caregiver)
Primary Purpose: Treatment
Low Back Pain
  • Other: neural mobilization
    stretch the nerve
  • Other: straight leg raise
    stretch the hamstring
    Other Name: hamstring stretching
  • Experimental: straight leg raise
    stretch the muscle
    Intervention: Other: straight leg raise
  • Experimental: neural mobilization
    stretch the nerve
    Intervention: Other: neural mobilization

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
50
December 2014
December 2014   (final data collection date for primary outcome measure)

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
Both
18 Years to 65 Years
No
Contact: Michael L D'Agati, PT, DPT 646-501-7077 dagatiml@shrp.rutgers.edu
Contact: Susan L Edmond, PT, DSc 973-972-9732 edmondsl@shrp.rutgers.edu
United States
 
NCT01483573
0120100079
No
Rutgers, The State University of New Jersey ( University of Medicine and Dentistry of New Jersey )
University of Medicine and Dentistry of New Jersey
Not Provided
Study Director: Susan L Edmond, PT, DSc, OCS University of Medicine and Dentistry
Rutgers, The State University of New Jersey
May 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP