Comparative Effects of Mulligan Bent Leg Raise Versus Spinal Mobilization With Leg Movement in Lumbar Radiculopathy

NCT07726823 | Recruiting

• 1 other identifier: REC/RCR&AHS/25/0132 Muniba
• Study Type: interventional
• Target: 52
• Locations: 1 country
• Sites: 1

Brief Summary

Lumbar radiculopathy is a spinal nerve root disorder often caused by lumbar disc herniation or compression, leading to radiating leg pain, restricted movement, and functional difficulties. This condition significantly disrupts daily activities and overall quality of life. While medication and exercise are common treatments, manual therapy techniques are gaining recognition for their non-invasive and effective outcomes in relieving symptoms and improving patient function.

Conditions

Lumbar Radiculopathy

Keywords

Neural Mobilization; Mulligan Technique; Manual Therapy

Outcome Measures

Primary Outcomes (5)

• NPRS for pain

  Pain intensity will be evaluated using the Numeric Pain Rating Scale, which ranges from 0 indicating "no pain" to 10 representing the "worst possible pain." It has shown excellent test-retest reliability, with intraclass correlation coefficients (ICC) ranging between 0.95 and 0.98 in individuals with musculoskeletal conditions

  upto 4 weeks

• SLR and Slump test for neural mobility

  To assess neural mobility, the Straight Leg Raise and Slump Tests will be employed. These are well-established clinical tools for identifying lumbar nerve root irritation. The SLR test demonstrates strong diagnostic accuracy (\~81%) and excellent inter-rater reliability with kappa values above 0.90 and aprox 0.71 for slump test

  Upto 4 weeks

• Oswestry Disability Index test for functional outcome

  The ODI will be used to determine the level of functional disability associated with lower back pain. It includes 10 items that assess various aspects of daily activity. The tool has proven to be highly reliable (Cronbach's alpha = 0.87) and valid across different patient populations with lumbar spine conditions

  Upto 4 weeks

• Time up and go (TUG) test for functional outcome

  Balance and functional mobility will be measured using the TUG test, which involves timing a patient as they rise from a chair, walk three meters, turn, return, and sit down. This test is highly reliable (ICC = 0.82 to 0.99) and shows good concurrent validity in both spinal and geriatric populations (34). The cutoff value for balance and functional mobility TUG test is 7.2 sec

  Upto 4 weeks

• Five repetition sit to stand test

  The 5 Rep Sit-to-Stand Test will be used to assess lower limb strength and functional performance. The patient gets to their maximum standing position and then sits back down five times as fast as they can without the use of their hands or arms. It has demonstrated excellent reliability (ICC \> 0.90) and shows strong correlation with functional ability (36). The cutoff value is \> 10 sec for 5 rep sitting to standing and standing to sitting transition

  upto 4 weeks

Study Arms (2)

Mulligan Bent Leg Raise (MBLR)

EXPERIMENTAL

The Mulligan Bent Leg Raise (BLR) technique is a specialized physical therapy mobilization method used to relieve low back pain, reduce sciatica, and improve hamstring flexibility. It involves applying gentle, pain-free traction while moving the leg through progressively greater ranges of hip flexion.

Other: Mulligan Bent Leg Raise (MBLR)

Spinal Mobilization with Leg Movement (SMWLM)

ACTIVE COMPARATOR

Spinal Mobilization with Leg Movement (SMWLM) is an advanced manual therapy technique developed as part of the Mulligan Concept. It integrates manual joint mobilization with neurodynamic principles to treat lower back and radiating leg pain, most notably lumbar radiculopathy (sciatica)

Other: Spinal Mobilization With Leg Movement (SMWLM)

Interventions

Mulligan Bent Leg Raise (MBLR) OTHER

Patient Position - Supine at edge of plinth * Affected hip and knee flexed to 90° * Hand of affected side under head and neck Therapist Position - Stands in walk stance, lateral to affected limb Therapist Hand Placement - Inner shoulder under popliteal fossa * Both hands grasp lower thigh Mobilization Procedure - Apply longitudinal traction along femur * Flex hip toward same side shoulder until first resistance * Patient performs isometric hold (5 sec) * On relaxation, increase hip flexion if pain free * Hold new position \~20 sec * Repeat 3 times if tolerated Precautions - Maintain knee flexion * No need to stabilize opposite leg

Mulligan Bent Leg Raise (MBLR)

Spinal Mobilization With Leg Movement (SMWLM) OTHER

Patient Position - Side-lying on unaffected side near edge * Affected leg on top, supported by assistant * Hip abducted \~10°, extended; knee flexed \~45° Therapist Position - Primary therapist behind pelvis * Assistant supports upper leg during movement Therapist Hand Placement - Supported thumb on spinous process of affected vertebra * Gentle transverse pressure maintained throughout movement Mobilization Procedure - Assistant helps patient actively lift leg (SLR) * Movement within pain free range * If symptoms appear, hold for \~3 sec then return * Start with 3 reps; increase to 6 with light overpressure as tolerated Precautions - Stay within non painful range * Maintain steady, controlled transverse pressure * Avoid excessive force, especially early on

Spinal Mobilization with Leg Movement (SMWLM)

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age 20 to 40 years (26)
• Diagnosed patient with Unilateral Lumbar Radiculopathy secondary to L4/L5 and L5/S1 lumbar posterolateral disc buldge confirmed on MRI (12)
• Posterolateral Lumbar Radiculopathy

You may not qualify if:

• Presence of red flags (e.g., cauda equina syndrome, severe neurological deficits).
• Previous spinal surgery within 1 year.
• Severe osteoporosis or vertebral fractures.
• Pregnant women.
• Systemic inflammatory or autoimmune diseases.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Femwell Physiocare Woman Rehab clinic

Lahore, Punjab Province, 54000, Pakistan

RECRUITING

Related Publications (10)

• Senol D, Erdem C, Canbolat M, Toy S, Karatas T, Baykara RA, Ozbag D, Akyurek G. Comparison of the effects of conventional physiotherapy and proprioception exercises on pain and ankle proprioception in patients with lumbar radiculopathy. J Back Musculoskelet Rehabil. 2022;35(2):421-428. doi: 10.3233/BMR-200361.

  PMID: 34308899 BACKGROUND

• Ashraf B, Ahmad S, Ashraf K, Kanwal S, Ashraf S, Khan N, et al. Effectiveness of spinal mobilization with leg movement versus McKenzie back extension exercises in lumbar radiculopathy. 2021;15(5):1436-40.

  BACKGROUND

• Fatima A, Mehmood Z, Ahmad SJJoIIMC. Effects of Mulligan Traction Straight Leg Raise Versus Passive Straight Leg Raise in Lumbar Radiculopathy Patients. 2022;17(2):86-90.

  BACKGROUND

• Singh V, Malik MJRJoN. Lumbar radiculopathy managed with spinal mobilization with leg movement: A case study. 2021;20(2):246-9.

  BACKGROUND

• Naidu SP, Srikantaiah S, Boyle RJIJoPT, Research. Immediate Effect of Mulligan's Spinal Mobilization with Limb Movements on Straight Leg Raise Test in Patients with Lumbar Radiculopathy: A Randomized Controlled Trial. 2023;5(1):66-72.

  BACKGROUND

• Singh V, Malik MJAiR. Effect of manual therapy on pain, disability and neural mobility in patients of lumbar prolapsed intervertebral disc: a randomized controlled trial. 2022;36(3):11-8.

  BACKGROUND

• Yasmeen S, Ahmad Z, Ishtiaq NJJRCoRS. The comparative effects of Butler's neural tissue mobilization and Mulligan's Bent leg raise in patients with chronic lumbar radiculopathy. 2022;10(02).

  BACKGROUND

• Lin LH, Lin TY, Chang KV, Wu WT, Ozcakar L. Neural Mobilization for Reducing Pain and Disability in Patients with Lumbar Radiculopathy: A Systematic Review and Meta-Analysis. Life (Basel). 2023 Nov 26;13(12):2255. doi: 10.3390/life13122255.

  PMID: 38137856 BACKGROUND

• Hussein H, Atteya M, Ansari A, Kamel E. A Systematic Review and Meta-Analysis of the Effectiveness of Mulligan Mobilization with Movement on Pain, Range of Motion, Function, and Flexibility in Patients with Sciatica. NeuroRehabilitation. 2025 Mar;56(2):83-96. doi: 10.1177/10538135241301693. Epub 2024 Dec 18.

  PMID: 40260717 BACKGROUND

• George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021 Nov;51(11):CPG1-CPG60. doi: 10.2519/jospt.2021.0304.

  PMID: 34719942 BACKGROUND

MeSH Terms

Conditions

Radiculopathy

Condition Hierarchy (Ancestors)

Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases

Study Officials

• Amna Zia, PhD

  King Edward Medical University

  PRINCIPAL INVESTIGATOR

• Muniba Tahir

  Riphah International University, Lahore Campus

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Amna Zia, PhD*

CONTACT

03244686993; amna.zia@kemu.edu.pk

Samrood Akram, PhD*

CONTACT

03324806143; samrood.akram@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 21, 2026
• First Posted: July 24, 2026
• Study Start: June 20, 2026
• Primary Completion (Estimated): August 20, 2026
• Study Completion (Estimated): September 20, 2026
• Last Updated: July 24, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)