Effect of Neural Mobilization Exercises in Patients With Low Back-Related Leg Pain With Peripheral Nerve Sensitization: A Prospective, Controlled Trial

J Chiropr Med. 2021 Jun;20(2):59-69. doi: 10.1016/j.jcm.2021.07.001. Epub 2021 Oct 2.

Abstract

Objective: The aim of this study was to investigate the short-term effect of slider and tensioner exercises on pain and range of motion (ROM) of straight leg raise (SLR) and slump tests in patients with low back-related leg pain with peripheral nerve sensitization.

Methods: In this prospective, controlled trial, 51 patients with low back-related leg pain with peripheral nerve sensitization were divided into 3 treatment groups: slider (slider neural mobilization exercise + transcutaneous electric nerve stimulation [TENS]), tensioner (tensioner neural mobilization exercise + TENS), and control (only TENS). Each patient received 6 sessions over 2 weeks. The following outcomes were measured at baseline and after the first, third, and sixth sessions: visual analog scale (VAS) for pain and ROM of SLR and slump tests were performed for the symptomatic side.

Results: Compared with controls, patients receiving the slider and tensioner exercises showed a greater decrease in pain at the third and sixth sessions (mean difference: ≥1.54 cm; 95% CI, 0.1-3.9). There was a significant difference in the ROM of the SLR test between the slider and controls at only the sixth session (mean difference: 16.7°; 95% CI, -29.2 to -4.3). Patients in the slider and tensioner groups demonstrated greater improvements in the ROM of slump test at all sessions compared with controls (mean difference: ≥12.5°; 95% CI, -32.1 to -6.4). There were no significant differences between the slider and tensioner groups in any outcome at any session.

Conclusion: Patients in both slider and tensioner neural mobilization exercise groups demonstrated improvements in pain and ROM in patients with low back-related leg pain with peripheral nerve sensitization compared to those in the control group.

Keywords: Low Back Pain; Radiculopathy; Range of Motion; Sciatica.