Srishti Sanat SHARMA, Megha SANDEEP SHETH

Effect of neurodynamic mobilization on pain and function in subjects with lumbo-sacral radiculopathy

Neurodynamic mobilization is a set of techniques designed to restore the plasticity of the nervous system and the ability of neural tissue to stretch and tension along with pain alleviation and functional improvement.The study aimed to determine the effect of neurodynamic mobilization on pain and function in subjects with lumbo-sacral radiculopathy.24 males and females between 25-50 years of age having low back pain radiating to any one lower limb since more than 3 weeks were randomly allocated into two groups.Group A received neural mobilization and conventional treatment.Group B received conventional treatment alone.Intervention was given for 6 sessions on 6 days/week.Pain and function were measured using Numerical Pain Rating Scale(NPRS) and Modified Oswestry Disability Index (MODI) respectively.Location of symptoms was also recorded using a body diagram.There was a significant difference in pain at rest and pain during activitywithin each group, but only group B showed significant difference in function. Pain during activity showed significant difference in group A over groupB(U=-1.47;p=0.04) along with function(U=-1.52;p=0.02). Compared to conventional treatment, there is significant decrease in pain during activity and improvement in function following neurodynamic mobilization,however there is no significant improvement pain at rest.

PDF

___

Shacklock M. Neurodynamics. Physiotherapy. 1995;81(1):9-16.

Talebi G, Taghipour-Darzi M, Norouzi-Fashkhami A. Treatment of chronic radiculopathy of the first sacral nerve root using neuromobilization techniques: A case study. J Back Musculoskelet Rehabil. 2010;23(3):151-9

Delitto A, George SZ, Dillen LV, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges, JJ. Low back pain: clinical practice guidelines. J Orthop Sports Phys Ther. 2012;42(4):1-57.

David J. Magee; Orthopaedic Physical Assessment; Chapter 9-Lumbar Spine; 5th edition: 558-64.

Jensen M, Turner J, Romano JM. What is the maximum number of levels needed in pain intensity measurement? Pain. 1994;58(3):387-92.

Fritz J and Irrgang J. A comparison of a modified Oswestry Low Back Disability Questionnaire and the Quebec Back Pain Disability Scale Phys Ther. 2001;81:776-88. Physical Therapy. Erratum in 2007;88(1):138-9.

Wernicke M, Hart D, Cook D. A Descriptive Study of the Centralization Phenomenon. Spine. 1999;24(7):676-83.

McCracking HV. The long-term effects of a neurodynamic treatment technique using a treatment-based classification approach to low back pain. J Man & Manipulative Ther. 2008;16(3):161-81.

Cleland J, Childs J, Palmer J, Eberhart S. Slump stretching in the management of non-radicular low back pain: A pilot clinical trial. Man Ther. 2006;11(4):279-86.

Bertolini G, Silva T, Trindade D, Ciena A, Carvalho A. Neural mobilization and static stretching in an experimental sciatica model: an experimental study. Braz J Phys Ther. 2009;13(6):493-8.

McGill S. Low back disorders: Evidence based prevention and rehabilitation. 2007. 2nd edition. Human kinetics. Ontario.

Sharma V, Sarkari E, Multani NK. Efficacy of neural mobilization in sciatica. Ind Journ of Phys and Occ Therapy. 2007;3(2): 136-41. 13. Sahar M. adel efficacy of neural mobilization in treatment of low back dysfunctions. J Am Sci. 2011;7(4):566-73.

Pallipamula K, Singaravelan RM. Efficacy of nerve flossing technique on improving sciatic nerve function in patients with sciatica– a randomized controlled trial. Revista română de kinetoterapie 2012;18(30):13-22.

Dabholkar T, Dabholkar AS, Gandhi K. Effect of neural mobilization on agility in asymptomatic subjects using sliders technique. Int Jour Therapies and Rehab Res. 2014;3(4):46-54