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Effects of adding a neurodynamic mobilization to motor control training in patients with lumbar radiculopathy due to disc herniation: a randomized clinical trial
Plaza-Manzano G, Cancela-Cilleruelo I, Fernandez-de-las-Penas C, Cleland JA, Arias-Buria JL, Thoomes-de Graaf M, Ortega-Santiago R
American Journal of Physical Medicine & Rehabilitation 2019 Sep 5:Epub ahead of print
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the effects of the inclusion of neural mobilization into a motor control exercise program on pain, related-disability, neuropathic symptoms, straight leg raise (SLR), and pressure pain threshold (PPT) in lumbar radiculopathy. DESIGN: A randomized clinical trial. METHODS: Individuals with LBP, with confirmed disc herniation, and lumbar radiculopathy were randomly assigned to receive 8 sessions of either neurodynamic mobilization plus motor control exercises (n = 16) or motor control exercises alone (n = 16). Outcomes included pain, disability, neuropathic symptoms, SLR, and PPT at baseline, after 4 visits, after 8 visits, and after 2-months. RESULTS: There were no between-groups differences for pain, related-disability, or PPT at any follow-up period since both groups get similar and large improvements. Patients assigned to the neurodynamic program group experienced better improvements in neuropathic symptoms and the SLR compared to the motor control exercise group (p < 0.01). CONCLUSION: The addition of neurodynamic mobilization to a motor control exercise program leads to reductions in neuropathic symptoms and mechanical sensitivity (SLR), but did not result in greater changes of pain, related-disability, or PPT over motor control exercises program alone in subjects with lumbar radiculopathy. Future trials are needed to further confirm these findings since between-groups differences did not reach clinically relevance.

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