SNAG and SNME in Non-Specific Sciatic Pain

NCT07161323 | Recruiting

• 1 other identifier: 28032025
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

This study is designed as a crossover trial. All participants who meet the inclusion criteria and voluntarily agree to participate will be evaluated using the assessment methods detailed below. Subsequently, participants will be randomly assigned into two groups. The first group (Mulligan Concept Group - MCG) will receive the SNAG technique, while the second group (Neural Mobilization Group - NMG) will perform the Sciatic Nerve Mobilization Exercise (SNME). After the intervention, participants will be evaluated a second time. Ten days after this session, participants will be invited back. Those who were in the MCG group during the first session will be re-evaluated and then receive the SNGE intervention. Participants who were in the SNGE group during the first session will be re-evaluated and then receive the SNAG intervention. Following this second intervention, participants will be evaluated once again. Assessments will be done are Demographic Form, Visual Analogue Scale, Oswestry Disability Index, Joint Range of Motion, Five-times Sit-to-stand Test, Sit and Reach Test

Conditions

Sciatica Pain; Sciatica Acute; Mulligan Mobilization

Keywords

Sciatic Nerve Pain; Mulligan Concept; Manual Therapy; Pain Management; Non-Specific Sciatica

Outcome Measures

Primary Outcomes (3)

• Oswestry Disability Index (ODI)

  The ODI assesses the impact of sciatic nerve pain on daily activities, including sitting, standing, walking, sleeping, and personal care. The total score indicates the level of disability.

  Through study completion, an average of 1 year

• 5 Times Sit to Stand Test

  The test will be used to measure the time it takes for an individual to rise from a seated position and sit back down. The participant is prepared in a seated position on a standard chair with a height of 43-46 cm, with their back against the chair and arms crossed over the chest. Upon the command to begin, the participant stands up fully and then completes the test by sitting down and standing up a total of five times as quickly as possible.

  Through study completion, an average of 1 year

• Sit and Reach Test

  The participant will sit on a mat placed on a flat surface, with legs extended straight forward and knees fully extended. The soles of the feet will be positioned vertically and kept stable. The participant will then reach forward with both arms, aiming to touch the toes or reach beyond them if possible. The reach distance will be recorded in centimeters based on how far the fingertips are from the soles of the feet.

  Through study completion, an average of 1 year

Secondary Outcomes (2)

• Range of Motion

  Through study completion, an average of 1 year

• Pain Intensity Visual Analog Scale (VAS)

  Through study completion, an average of 1 year

Study Arms (2)

Mulligan Consept Group (MCG)

EXPERIMENTAL

Other: Sustained Natural Apophyseal Glide (SNAG)

Neural Mobilization Group (NMG)

EXPERIMENTAL

Other: Sciatic Nerve Mobilization Exercises (SNME)

Interventions

Sustained Natural Apophyseal Glide (SNAG) OTHER

In this intervention, participants will initially receive the SNAG technique targeting the L5-S1 lumbar segment. Participants will be seated on a treatment table with feet flat and knees at 90°. The therapist will position a specialized Mulligan belt around the L5-S1 segment and anchor it around their pelvis to generate a gentle traction force via controlled hip movement. While this force is applied, participants will perform active trunk flexion, holding the end-range position for 30 seconds. This movement will be repeated six times, constituting a 3-minute set. A total of 4 sets will be administered, with 2-minute rest periods between sets.

Mulligan Consept Group (MCG)

Sciatic Nerve Mobilization Exercises (SNME) OTHER

Participants will sit with hips and knees at 90° flexion, feet flat on the floor. The involved leg will be fully extended at the knee. In this position, the participant will be asked to perform ankle dorsiflexion and neck extension simultaneously (applying tension to the distal part of the sciatic nerve while relaxing the proximal part) and hold for 3 seconds. Next, the participant will plantarflex the ankle and flex the neck (tensioning the proximal end while relaxing the distal), again holding for 3 seconds. This 6-second sequence will be repeated 10 times per set. The exercise will be performed in 3 sets per leg, with 3-minute rests between sets.

Neural Mobilization Group (NMG)

Eligibility Criteria

• Age: 20 Years - 50 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Adults between the ages of 20 and 50,
• Individuals describing non-specific sciatic pain characterized by unilateral low back pain accompanied by radiating symptoms to the leg,
• Duration of pain longer than 12 weeks,
• Presence of pain during the Slump Test and Straight Leg Raise Test,
• No history of any physical therapy or intervention in the past month.

You may not qualify if:

• Individuals diagnosed with herniated disc or spinal stenosis by a physician,
• Physician-diagnosed secondary neurological conditions,
• History of spinal surgery,
• Individuals describing the origin of their pain as the lower back (without leg involvement),
• Presence of neurological symptoms (e.g., foot drop, significant muscle weakness),
• Serious medical conditions that may affect treatment or outcomes (e.g., cancer, infections, or inflammatory diseases),
• Pregnancy or recent childbirth (within the past year),
• Use of medications that may affect pain perception or mobility (e.g., opioids),
• Inability to comply with the weekly treatment schedule.

Sponsors & Collaborators

• Istinye University: lead

Study Sites (1)

Clam Fizyoterapi Merkezi

Istanbul, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Agnosia

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Çiçek Günday, Asst.Prof.

  Istinye University

  PRINCIPAL INVESTIGATOR

• Sohiab Hassan Mohamed Wagdy Ahmed Elsayed Eladawi, Physiotherapist

  Istinye University

  STUDY CHAIR

Central Study Contacts

Sohiab Hassan Mohamed Wagdy Ahmed Elsayed Eladawi, Physiotherapist

CONTACT

+905415142895; sohiabhasan@gmail.com

Çiçek Günday, Asst.Prof.

CONTACT

+905071888848; cicek.gunday@istinye.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Asst. Prof.

Study Record Dates

• First Submitted: July 30, 2025
• First Posted: September 8, 2025
• Study Start: July 1, 2025
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): July 1, 2026
• Last Updated: September 8, 2025

Record last verified: 2025-09

Locations

TU (1)