ABSTRACT
OBJECTIVES: To investigate if neurodynamic treatment is more effective than advice to remain active in patients with nerve-related leg pain. DESIGN: Parallel-group randomized controlled trial blinded to the outcome assessor conducted in Porto Alegre, Brazil. PARTICIPANTS: Sixty patients recruited from the community and private practices. INTERVENTION: Patients will be randomly assigned to receive four sessions of neurodynamic treatment over two weeks comprising passive lumbar foramen opening and neurodynamic sliders plus home exercises or advice to remain active. MAIN OUTCOME MEASURES: Leg pain intensity, disability, low back pain intensity, functional ability, symptoms distribution and global impression of recovery will be assessed at two and four weeks after randomization. ANALYSIS: A linear mixed model will be employed for each outcome following intention to treat principles.
Subject(s)
Low Back Pain/rehabilitation , Physical Therapy Modalities , Sciatica/rehabilitation , Adolescent , Adult , Aged , Aged, 80 and over , Brazil , Disability Evaluation , Female , Humans , Male , Middle Aged , Pain Measurement , Range of Motion, Articular , Research Design , Single-Blind Method , Young AdultABSTRACT
OBJECTIVE: The mechanisms underlying the effects of neurodynamic techniques are still unknown. Therefore, the aim of this study was to provide a starting point for future research on explaining why neurodynamic techniques affect muscular activities in patients with sciatic pain. METHODS: A double-blind trial was conducted in 12 patients with lumbosciatica. Surface electromyography activity was assessed for different muscles during prone hip extension. Pre- and post-intervention values for muscle activity onset and maximal amplitude signals were determined. RESULTS: There was a significant reduction in the surface electromyography activity of maximal amplitude in the erector spinae and contralateral erector spinae (p < 0.05). Additionally, gluteus maximus (p < 0.05) activity onset was delayed post-intervention. CONCLUSIONS: Self-neurodynamic sliding techniques modify muscular activity and onset during prone hip extension, possibly reducing unnecessary adaptations for protecting injured components. Future work will analyze the effects of self-neurodynamic sliding techniques during other physical tasks.