Effect of spinal mobilization with leg movement as an adjunct to neural mobilization and conventional therapy in patients with lumbar radiculopathy: Randomized controlled trial

Abstract

Background: In lumbar radiculopathy there is compression or inflammation of a spinal nerve and it may be accompanied by numbness and tingling, muscle weakness or loss of spinal reflexes in one or both lower limbs. Conventional physiotherapy which includes back extension exercises has varying degree of success in pain and functional outcome in lumbar radiculopathy. Mulligan's spinal mobilization with limb movement (SMWLM) and Shacklock's neural tissue mobilization are few of the techniques employed in the management of lumbar radiculopathy. The purpose of the study was to find out whether spinal mobilization with leg movement as an adjunct to neural mobilization and conventional therapy could bring better outcome in patients when compared to conventional therapy or neural mobilization and conventional therapy. Methods: 90 patients were selected randomly with lumbar radiculopathy. Duration of the study was for six weeks. The study included 3 groups, control group received back extension exercises and hot pack, experimental group 1 received neural mobilisation and conventional physiotherapy and experimental group 2 received SMWLM along with neural mobilisation and conventional physiotherapy. The outcomes included NPRS, SLR using goniometry and MOLBPQ which were assessed at day 1 and 2, 4, 6 week. ANOVA was done for inter group analysis and paired t-test was done for intra group analysis. Results: All the groups showed significant difference (P -0.000 < 0.05) at 2, 4, 6 weeks of NPRS, MOLBPQ and SLR. The mean difference and paired t-test values of experimental group 2 was more when compared to experimental group 1 and control group at the end of 6 weeks. Conclusion: All the three groups showed improvement in pain, functional disability and straight leg raise (SLR). SMWLM as an adjunct to neural mobilization and conventional therapy showed significantly better outcomes in pain, functional disability and SLR when compared to conventional therapy or neural mobilization and conventional therapy.

Keywords

• lumbar radiculopathy
• spinal mobilization
• leg movement
• neural mobilization
• conventional therapy