The Role of Lower Limb Neural Mobilization in Improving Balance and Performance

NCT06951048 | Completed

• 1 other identifier: 2025/4-1
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Neural mobilization (NM) is a technique used to enhance the mobility of peripheral nerves relative to surrounding tissues, aiming to reduce physiological tension and improve movement quality. While its effects are well-documented in clinical populations, recent studies have explored its use in healthy individuals to improve flexibility, balance, and functional performance. Evidence supports its positive impact on hamstring flexibility; however, findings on balance and performance remain inconclusive. This study aims to examine the effects of lower extremity NM techniques on balance, flexibility, and functional performance in healthy individuals, addressing current gaps in the literature.

Conditions

Healty Volunteers; Sedantary; Young; Female

Keywords

Neural Mobilisation; Performance; Balance; Reactive agility

Outcome Measures

Primary Outcomes (4)

• Reactive Agility Test

  Y-shaped course will be set up using three cones spaced 2 meters apart. Participants start by sprinting from the starting line; at the middle cone, a test administrator will randomly direct them to run left or right toward the finish line. Time will be recorded from the start to finish, and the best of three trials will be used for analysis.

  Baseline and at Week 2

• Y Balance Test

  This test assesses balance and stability. Participants will reach in three directions: anterior, 135° posteromedial, and 135° posterolateral using a prepared setup. After six practice attempts per direction, three test trials will be recorded, and the best score will be used. Lower limb length will be measured from the anterior superior iliac spine to the medial malleolus.

  Baseline and at Week 2

• Active Straight Leg Raise Test

  Used to assess hamstring flexibility. The test leg is lifted straight (without knee flexion) three times, and the highest angle of hip flexion measured with a goniometer will be recorded.

  Baseline and at Week 2

• Muscle Strength

  Isometric strength of the lower extremity will be measured using the Lafayette Manual Muscle Testing System Model-01165 (Lafayette Instrument Company, Lafayette IN, USA). Maximum isometric contraction will be measured in both knee flexion and extension with participants seated at 90° hip and knee flexion. Each contraction will last 5 seconds, repeated three times, and the average value will be used.

  Baseline and at Week 2

Study Arms (3)

Group I (Neural Mobilization)

EXPERIMENTAL

This group will follow a neural mobilization protocol targeting the sciatic, femoral, and tibial nerves. Neural exercises will be applied using specific techniques to facilitate nerve sliding along its anatomical path. Each nerve mobilization will be performed in 4 sets of 10 repetitions, three times a week (non-consecutive days).

Other: Group I (Neural Mobilization)

Group II (Neural Mobilization + Dynamic Stretching)

ACTIVE COMPARATOR

This group will perform the same neural mobilization protocol as Group I, in addition to dynamic stretching exercises targeting the lower extremities. The dynamic stretching program includes active straight leg raises (SLR), vertical jumps, and 10-meter sprints, performed in 3 sets of 10 repetitions for each exercise.

Other: Group II (Neural Mobilization + Dynamic Stretching)

Group III (Dynamic Stretching Only)

ACTIVE COMPARATOR

This group will follow a dynamic stretching protocol consisting of the same SLR, vertical jump, and 10-meter sprint exercises, performed in 3 sets of 10 repetitions.

Other: Group III (Dynamic Stretching Only)

Interventions

Group I (Neural Mobilization) OTHER

Participants will undergo a neural mobilization program targeting the sciatic, femoral, and tibial nerves. Exercises are designed to promote nerve sliding through specific movement patterns and are performed bilaterally. Each nerve mobilization is applied in 4 sets of 10 repetitions, three times per week on non-consecutive days, with 30-second rest intervals. Sciatic nerve: Performed in side-lying; ankle dorsiflexion with neck extension followed by dorsiflexion release and neck flexion. Femoral nerve: In side-lying; simultaneous movements of the hip, knee, and neck in flexion and extension. Tibial nerve: In supine; coordinated ankle, toe, and cervical spine movements with controlled hip/knee positioning.

Group I (Neural Mobilization)

Group II (Neural Mobilization + Dynamic Stretching) OTHER

Participants in this group will engage in the same neural mobilization protocol applied in Group I, combined with a structured dynamic stretching program targeting lower extremity flexibility and neuromuscular performance. The dynamic exercises include active straight leg raises (SLR), vertical jumps, and 10-meter sprints. Each activity will be performed in three sets of ten repetitions, aiming to enhance muscular activation, mobility, and functional readiness.

Group II (Neural Mobilization + Dynamic Stretching)

Group III (Dynamic Stretching Only) OTHER

This group will engage exclusively in a dynamic stretching protocol comprising active straight leg raises (SLR), vertical jump exercises, and 10-meter sprint drills. Each exercise will be performed in three sets of ten repetitions, focusing on enhancing lower extremity mobility, muscle activation, and functional movement capacity without any neural mobilization intervention.

Group III (Dynamic Stretching Only)

Eligibility Criteria

• Age: 18 Years - 30 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Providing written informed consent to voluntarily participate in the study
• Being a female individual aged between 18 and 30 years
• Having no medical conditions that contraindicate participation in physical exercise

You may not qualify if:

• Presence of structural spinal deformities such as scoliosis
• History of lumbar or lower extremity surgery within the past 12 months
• Experience of localized pain in the lumbar or lower extremity regions within the past 3 months
• Diagnosis of any neurodegenerative or neuromuscular disorders
• Presence of any medical condition that may hinder or contraindicate safe participation in exercise interventions

Sponsors & Collaborators

• Uludag University: lead

Study Sites (1)

Bursa Uludag University

Bursa, Nilüfer, Turkey (Türkiye)

Location

Related Publications (5)

• Castellote-Caballero Y, Valenza MC, Martin-Martin L, Cabrera-Martos I, Puentedura EJ, Fernandez-de-Las-Penas C. Effects of a neurodynamic sliding technique on hamstring flexibility in healthy male soccer players. A pilot study. Phys Ther Sport. 2013 Aug;14(3):156-62. doi: 10.1016/j.ptsp.2012.07.004. Epub 2012 Nov 8.

  PMID: 23142014 BACKGROUND

• Waldhelm A, Gacek M, Davis H, Saia C, Kirby B. ACUTE EFFECTS OF NEURAL GLIDING ON ATHLETIC PERFORMANCE. Int J Sports Phys Ther. 2019 Jul;14(4):603-612.

  PMID: 31440411 BACKGROUND

• Ferreira J, Bebiano A, Raro D, Martins J, Silva AG. Comparative Effects of Tensioning and Sliding Neural Mobilization on Static Postural Control and Lower Limb Hop Testing in Football Players. J Sport Rehabil. 2019 Nov 1;28(8):840-846. doi: 10.1123/jsr.2017-0374.

  PMID: 30222495 BACKGROUND

• Heredia Macias C, Paredes Hernandez V, Fernandez Seguin LM. A systematic review of the efficacy of neural mobilisation in sport: A tool for the neural tension assessment. J Bodyw Mov Ther. 2024 Oct;40:1409-1416. doi: 10.1016/j.jbmt.2023.04.034. Epub 2023 Apr 17.

  PMID: 39593463 BACKGROUND

• Gunay SM, Erturk E. Effects of lower limb neural mobilisation on reactive agility, balance, and physical performance: a randomised controlled trial. BMC Sports Sci Med Rehabil. 2025 Dec 10;18(1):1. doi: 10.1186/s13102-025-01461-3.

  PMID: 41372947 DERIVED

Related Links

• Related Info

MeSH Terms

Interventions

Muscle Stretching Exercises

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor of Physical Therapy

Study Record Dates

• First Submitted: April 22, 2025
• First Posted: April 30, 2025
• Study Start: March 1, 2025
• Primary Completion: June 1, 2025
• Study Completion: July 1, 2025
• Last Updated: July 9, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)