Comparative Effects of Dynamic Stretching Versus Slider Neurodynamic Technique In Patients With Lumbar Radiculopathy

NCT07384832 | Completed DMC

• 1 other identifier: UOL/IREB/25/09/0043
• Study Type: interventional
• Target: 72
• Locations: 1 country
• Sites: 1

Brief Summary

This study will be a randomised clinical trial conducted at the University of Lahore Teaching Hospital, Lahore, Pakistan. A total of 72 participants will be selected and randomly allocated into two treatment groups (36 participants in each group) using the lottery method. All screened and willing participants who meet the eligibility criteria will be assigned to either Group A or Group B. Group A will receive dynamic stretching along with routine physiotherapy. Routine physiotherapy will include TENS (15 minutes), hot moist pack (10 minutes), soft tissue mobilisation (5-7 minutes), abdominal bracing, pelvic tilt, and alternate leg extension exercises. The dynamic stretching part will include the slump stretch, cat-camel stretch, hamstring sweeps, child pose stretch, and overhead lateral stretch. Each stretch will be performed in 2 sets of 15-20 repetitions with 1-minute rest between sets. Treatment will be provided four times per week for 6 weeks. Group B will receive slider neurodynamic mobilisation along with the same routine physiotherapy protocol as group A. Slider neurodynamic mobilisation will be performed in the slump position, sitting at the edge of the plinth with the thighs parallel to each other and arms crossing behind the back. The examiner asked the patient to move actively and conversely from a position of neck and trunk flexion, knee flexion, and plantar flexion, to a position of neck and trunk extension, knee extension, and ankle dorsiflexion with 3 sets of 1-minute sliders and 1-minute rest between sets. Treatment will be provided four times per week for 6 weeks. All participants will undergo assessments at baseline, at the end of the 3rd week, and at the end of the 6th week.

Conditions

Lumbar Radiculopathy

Keywords

lumbar radiculopathy; sciatica

Outcome Measures

Primary Outcomes (1)

• Pain Intensity (NPRS)

  Pain Intensity will n=be measured using the numeric pain rating scale (NPRS) , where participants rate their pain on a scale from 0 to 10 (0= no pain, 10= worst possible pain). the scale will be used to assess changes in pain levels over the duration of the intervention.

  baseline, 3rd week, 6th week

Secondary Outcomes (2)

• Functional Disability (Modified Oswestry Disability Index -MODI)

  baseline,3rd week, 6th week

• Lumbar Flexion Range of Motion (Modified-Modified Schober Test - MMST)

  baseline, 3rd week, 6th week

Study Arms (2)

Dynamic Stretching + Routine Physiotherapy

EXPERIMENTAL

Participants in this group will receive Dynamic stretching Includes slump stretch, cat and camel, hamstring sweeps, child pose, and overhead lateral stretch. Protocol: 2 sets of 10-15 repetitions for 4 minutes with 1-minute rest intervals

Other: Dynamic stretching; Other: Routine physiotherapy

Slider Neurodynamic Mobilization + Routine Physiotherapy

EXPERIMENTAL

Participants in this arm will receive Slider Neurodynamic Mobilization (NDM) along with routine physiotherapy. NDM slider techniques will be performed in the slump position according to a standardised protocol ( the patient to move actively and conversely from a position of neck and trunk flexion, knee flexion, and plantar flexion, to a position of neck and trunk extension, knee extension, and ankle dorsiflexion ) protocol: 3 sets of 1 minute slider movement with 1 minute rest interval

Other: slider neurodynamic mobilization; Other: Routine physiotherapy

Interventions

Dynamic stretching OTHER

Dynamic stretching protocol will include: * Slump Stretch (4 minutes): The patient performed a slump stretch, seated with knees bent, extending one leg at a time while flexing the trunk forward to stretch the lumbar nerve roots. * Cat and Camel Stretch (4 minutes): The patient alternated between spinal flexion and extension while on hands and knees. * Hamstring Sweeps (4 minutes): The patient performed dynamic hamstring stretches, sweeping the leg forward and back to increase flexibility in the posterior chain. * Child's Pose Stretch (4 minutes): The patient performed a child's pose stretch to improve flexibility in the lower back and hips. * Overhead Lateral Stretch (4 minutes): The patient performed a side stretch to target the quadratus lumborum and obliques, releasing tension from the side of the back. Each dynamic stretch will be performed as follows: * 2 sets of 10-15 repetitions * 1-minute rest between sets * Performed 3 sessions/week for 6 weeks

Dynamic Stretching + Routine Physiotherapy

slider neurodynamic mobilization OTHER

Performed in the slump sitting position. Participants move from neck and trunk flexion with knee flexion and plantar flexion toward neck and trunk extension with knee extension and ankle dorsiflexion. The protocol consists of 3 sets of 1-minute slider movements, each followed by 1 minute of rest.

Slider Neurodynamic Mobilization + Routine Physiotherapy

Routine physiotherapy OTHER

TENS: Conventional Transcutaneous Electrical Nerve Stimulation was applied for 15 minutes (70 Hz frequency, 100 μs pulse width). Two 40×40 mm electrodes were positioned in a crossed pattern bilaterally over the lumbosacral region. A hot moist pack was applied to the lumbosacral and gluteal regions for 10 minutes in prone lying.Strengthening and Stabilization Exercises: Pelvic tilts were performed in crook-lying with 10-15 second holds. Alternate leg extensions were performed in prone with 10-second holds. Quadriceps and hip adductor/abductor strengthening were completed using isometric contractions (e.g., pillow squeeze)..All exercises were performed in 2 sets of 15-20 repetitions with 1 min rest. and lumbar traction.

Dynamic Stretching + Routine Physiotherapy; Slider Neurodynamic Mobilization + Routine Physiotherapy

Eligibility Criteria

• Age: 25 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• \- • Participants aged between 25 - 50 years of both genders are included
• Symptoms that radiate below the buttocks, thigh/ knee, and lower leg for more than 4 weeks.
• A minimum baseline Pain intensity (NPRS) \>4/10. (Morsi et al., 2022)
• Diagnosis of discogenic low back pain (LBP) confirmed by MRI ( disc bulge, protrusion, and herniation) and referred by an orthopedic physician.
• LBP due to muscle tightness/ or nerve compression.
• Had a positive slump test with reproduction of neurological symptoms, and had functional disabilities in certain daily tasks as lifting or walking.

You may not qualify if:

• Patients with lumbar spondylolisthesis.
• Currently pregnant women or in the early post-partum period.
• Patients with autoimmune disease (ankylosing spondylitis, RA)
• Previous history of trauma ( fracture, soft tissue injuries) or spinal surgery (spinal laminectomy).
• Systemic diseases like cardiovascular disease( unstable angina, uncontrolled cardiac arrhythmias) and metabolic diseases.
• Contraindication to exercises or usage of TENS (cardiac pacemaker, skin allergies to electrodes).

Sponsors & Collaborators

• University of Lahore: lead
• University of Lahore Hospital (ULH): collaborator

Study Sites (1)

University of Lahore Teaching Hospital

Lahore, Punjab Province, 55150, Pakistan

Location

Related Publications (5)

• Shaheen HM, Belgen Kaygisiz B. Comparison of different treatment positions of nerve slider technique for patients with low back pain: a randomized control trial. Eur J Phys Rehabil Med. 2025 Feb;61(1):82-92. doi: 10.23736/S1973-9087.24.08541-1. Epub 2025 Jan 28.

  PMID: 39873676 RESULT

• Nahid ZBS, Ahmed F, Islam MF, Rahman Z, Haque MF, Arju A, Islam MR, Moula G, Sarker B. Effectiveness of Shacklock's Neural Mobilization for Acute and Sub-Acute Lumbar Disc Prolapsed: A Randomized Controlled Trial. Health Sci Rep. 2025 May 26;8(5):e70872. doi: 10.1002/hsr2.70872. eCollection 2025 May.

  PMID: 40432703 RESULT

• de Ridder R, De Blaiser C, Verrelst R, De Saer R, Desmet A, Schuermans J. Neurodynamic sliders promote flexibility in tight hamstring syndrome. Eur J Sport Sci. 2020 Aug;20(7):973-980. doi: 10.1080/17461391.2019.1675770. Epub 2019 Oct 22.

  PMID: 31578925 RESULT

• Danazumi MS, Bello B, Yakasai AM, Kaka B. Two manual therapy techniques for management of lumbar radiculopathy: a randomized clinical trial. J Osteopath Med. 2021 Feb 26;121(4):391-400. doi: 10.1515/jom-2020-0261.

  PMID: 33705612 RESULT

• Ghaderi Niri H, Ghanavati T, Mostafaee N, Salahzadeh Z, Divandari A, Adigozali H, Ahadi J. Oswestry Disability Index, Roland-Morris Disability Questionnaire, and Quebec Back Pain Disability Scale: Responsiveness and Minimal Clinically Important Changes in Iranian People with Lumbar Disc Herniation Following Physiotherapy. Arch Bone Jt Surg. 2024;12(1):58-65. doi: 10.22038/ABJS.2023.72246.3366.

  PMID: 38318303 RESULT

MeSH Terms

Conditions

Radiculopathy; Sciatica

Interventions

Muscle Stretching Exercises

Condition Hierarchy (Ancestors)

Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Sciatic Neuropathy; Mononeuropathies; Neuralgia; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

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 Officials

• Asim Arif, PhD

  University of Lahore

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: This study used a single-blind approach. This means that while the researchers knew which treatment each person was getting, the patients did not know if they were in the "Dynamic Stretching" group or the "Slider Neurodynamic" group. They were not told which exercise protocol was the main focus of the study or which one was expected to be more effective. This helps ensure that the patients' expectations did not influence the results or their reporting of pain levels.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 26, 2026
• First Posted: February 3, 2026
• Study Start: June 20, 2025
• Primary Completion: January 30, 2026
• Study Completion: February 10, 2026
• Last Updated: April 14, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)