The Effectiveness of Neurodynamic Techniques in Patients With Nerve-Related Leg Pain

Sponsor

Federal University of Health Science of Porto Alegre (Other)

Overall Status

Completed

CT.gov ID

NCT01954199

Collaborator

(none)

Enrollment

Location

Arms

Duration (Months)

4.6

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

This study aims to verify if patients with nerve-related leg pain benefits from neurodynamic treatment over two weeks.

Condition or Disease	Intervention/Treatment	Phase
Nerve Pain Peripheral Nerve Injuries Peripheral Nervous System Diseases Sciatica Low Back Pain Low Back Ache Signs and Symptoms	Procedure: Neurodynamic Group	N/A

Detailed Description

Nerve-related leg pain (NRLP) although less prevalent than low back pain itself, is associated with higher economic and social burden, and has been considered a predictor of chronicity and disability among subjects with low back pain.

Numerous approaches are proposed for its management; however, evidence regarding the best therapeutic approach is lacking. Neurodynamic techniques are proposed to be effective to manage NRLP.

Thus, this study aims to verify, through a randomized controlled trial, the effectiveness of a two-week program of neurodynamic techniques on pain and disability in individuals with NRLP.

Study Design

Study Type:

Interventional

Actual Enrollment :

60 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Single (Outcomes Assessor)

Primary Purpose:

Treatment

Official Title:

The Effectiveness of Neurodynamic Techniques in Patients With Nerve-Related Leg Pain

Study Start Date :

Mar 1, 2015

Actual Primary Completion Date :

Apr 1, 2016

Actual Study Completion Date :

Apr 1, 2016

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Neurodynamic group Patients allocated to this group will receive three different neurodynamic techniques: a lumbar foramen dynamic opener; a side-lying slider and a slider in the slump position. Patients will be asked to perform home exercises (a slider and a tensioner technique). Treatment will receive four treatments during two weeks (two sessions/week).	Procedure: Neurodynamic Group All techniques will be executed in a pain-free way (grade III). Mild discomfort will be accepted, but it must subside as soon as the technique ends. In the dynamic opener technique, patient will be positioned in side-lying, with the affected side upwards. The therapist will then perform grade III oscillations aiming to open the lumbar foramen; In the side-lying slider, the patient will be in side-lying with the affected side upwards. A combination of knee and hip flexion and extension movements will produce sliding in the neural structures; In the slump slider, the patient will be seated in slump position. Combinations between neck and knee movements will produce greater nerve excursion than the side-lying slider. Patients will perform the slump slider in a pain-free manner. Other Names: Neural mobilization Sliders Tensioners Nerve tissue management
No Intervention: Control Group Patients allocated to Control Group (CG) will receive no intervention and will be advised according to the best evidence available; i.e, advice to remain active and to resume activities of daily living Upon trial completion, treatment will be offered.

Arm

Intervention/Treatment

Experimental: Neurodynamic group

Patients allocated to this group will receive three different neurodynamic techniques: a lumbar foramen dynamic opener; a side-lying slider and a slider in the slump position. Patients will be asked to perform home exercises (a slider and a tensioner technique). Treatment will receive four treatments during two weeks (two sessions/week).

Procedure: Neurodynamic Group

All techniques will be executed in a pain-free way (grade III). Mild discomfort will be accepted, but it must subside as soon as the technique ends. In the dynamic opener technique, patient will be positioned in side-lying, with the affected side upwards. The therapist will then perform grade III oscillations aiming to open the lumbar foramen; In the side-lying slider, the patient will be in side-lying with the affected side upwards. A combination of knee and hip flexion and extension movements will produce sliding in the neural structures; In the slump slider, the patient will be seated in slump position. Combinations between neck and knee movements will produce greater nerve excursion than the side-lying slider. Patients will perform the slump slider in a pain-free manner.

Other Names:

Neural mobilization

Sliders

Tensioners

Nerve tissue management

No Intervention: Control Group

Patients allocated to Control Group (CG) will receive no intervention and will be advised according to the best evidence available; i.e, advice to remain active and to resume activities of daily living Upon trial completion, treatment will be offered.

Outcome Measures

Primary Outcome Measures

Leg Pain Intensity [Two weeks after randomization]
Leg Pain will be measured by a 0-10 Numeric Rating Scale (Pain NRS)
Disability [Two weeks after randomization]
Disability will be measured by the Oswestry Disability Index (ODI)

Secondary Outcome Measures

Leg pain Intensity [Four weeks after randomization]
Leg Pain will me measured by a 0-10 Pain NRS
Disability [Four weeks after randomization]
Disability will be measured by the Oswestry Disability Index (ODI)
Back pain intensity [Two weeks after randomization]
Back Pain will me measured by an 0-10 Pain NRS
Back pain intensity [Four weeks after randomization]
Back Pain will me measured by an 0-10 Pain NRS
Distribution of Symptoms [Two weeks, Four weeks after randomization]
Distribution of symptoms will me measured by a body diagram
Function [Two weeks, Four weeks after randomization]
Function will be measured by the Patient-Specific Functional Scale (PSFS)
Global Perceived Effect [Two weeks, Four weeks after randomization]
Global Perceived Effect will be measured by an 11-point (-5 to +5) Global Perceived Effect Scale

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 80 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion criteria:

unilateral leg pain (Intensity ≥ 3)
Pain distal to the buttocks
Reproduction of symptoms and change in symptoms with structural differentiation (cervical return to neutral position or ankle dorsiflexion) with slump test;