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Trial registered on ANZCTR
Registration number
ACTRN12617000887370
Ethics application status
Approved
Date submitted
14/05/2017
Date registered
16/06/2017
Date last updated
8/02/2021
Date data sharing statement initially provided
8/02/2021
Date results provided
8/02/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Crossover effects of ultrasound-guided percutaneous neuromodulation on contralateral hamstring flexibility.
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Scientific title
Immediate Bilateral Effects of Percutaneous Neuromodulation Therapy on Hamstring Flexibility in Subjects with Short Hamstring Syndrome
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Secondary ID [1]
291868
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Short Hamstring Syndrome
303154
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Hamstring Flexibility
303155
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Condition category
Condition code
Musculoskeletal
302600
302600
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
There are 3 different groups receiving one of each treatment:
1. Percutaneous Electrical Stimulation (PES group). Subjects in the PES Group received the PES thecnique in the perineurium of the sciatic nerve. Specifically, this intervention consisted in the application of an asymmetric biphasic rectangular current of 150 microseconds and 10 Hz using a specifically developed medically certified device (Physio Invasive, Enraf Nonius, Prim, SPAIN). The subject lay prone with his feet outside the table. The sciatic nerve was located at 50% of the distance between the greater trochanter and interlinear articular knee by ultrasound machine (cross-section) (Logiq, GE Healthcare, USA) and then, a needle (0.30mm x 0.40mm) was inserted, perpendicular to the surface of the skin, until the perineurium of sciatic nerve. Prior to inserting a needle, the underlying skin was cleaned with isopropyl alcohol. The intensity of the current was necessary to cause an exacerbated muscle contraction, according to the Valera and Minaya protocol´s: once-off 1.5 mins session, current was applied every 4 times cycle for 20 s.
The intervention will be performed in the department of Physicaltherapy in the University of Seville by a sports physiotherapist with an experience of more than 5 years.
2. Passive Stretching Technique. Subjects in the Stretching group received passive stretching of the hamstring muscles in their dominant leg. While lying supine, a researcher who was blinded to SLR test measures would passively position the subject into the SLR position (hip in flexion, knee in extension, and ankle in neutral) without pain/discomfort to the point where resistance to movement was first noted. This position was then maintained for 20 seconds and repeated further 4 times. During the 20 second stretches, the therapist monitored the subjects to ensure they did not make any compensation that could modify the stretching position. Each subject had a total of 1.5 minutes of stretching on their lower extremity.
3. Neurodynamic Sliding Technique. Subjects in the Neurodynamic group received sciatic neurodynamic sliders, performed in supine. The objective of the technique is to produce a sliding movement of neural (sciatic) structures relative to their adjacent tissues . Sliders involve the application of movement/stress to the nervous system proximally while releasing movement/stress distally and then reversing the sequence. Recent research has shown that sliders actually result in greater excursion than simply stretching the nerve. Subjects were supine with their neck and thoracic spine supported in a forward flexed position. Concurrent hip and knee flexion were alternated dynamically with concurrent hip and knee extension. The therapist alternated the combination of movement depending on the tissue resistance level. This combination of movements was performed for 1.5 minutes on their dominant lower extremity.
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Intervention code [1]
297985
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Prevention
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Intervention code [2]
297986
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Rehabilitation
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Intervention code [3]
298175
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Treatment: Other
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Comparator / control treatment
Mechanical Stimulation (Needle group). Subjects in the Needle Group received mechanical stimulation in the perineurium of the sciatic nerve through a needle. The sciatic nerve was located at 50% of the distance between the greater trochanter and interlinear articular knee by ultrasound machine (cross-section) (Logiq, GE Healthcare, USA) and then, a needle (0.30mm x 0.40mm) was inserted, perpendicular to the surface of the skin, until the perineurium of sciatic nerve. Prior to inserting a neddle, the underlying skin was cleaned with isopropyl alcohol. This intervention was performed during 1.5 min.
Every interventions will be performed in the department of Physicaltherapy in the University of Seville by a sports physiotherapist with an experience of more than 5 years.
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Control group
Active
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Outcomes
Primary outcome [1]
302012
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The range of hip motion, assessed by passive straight leg raise test (SLR)
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Assessment method [1]
302012
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Timepoint [1]
302012
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Baseline and after intervention
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Secondary outcome [1]
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muscular activity assessed by tensiomyography
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Assessment method [1]
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Timepoint [1]
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Baseline and after intervention
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Eligibility
Key inclusion criteria
Young people, SLR test<=70 degree
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Minimum age
18
Years
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Maximum age
30
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria were hamstring injury within the past year, a Personal Psychological Apprehension Scale (PPAS) score >37.5, verbal report of performing regular lower extremity muscle stretching exercises, history of neck trauma (whiplash), neck symptoms, history of fracture in any part of the body, history of growth disorders, history of neurological or orthopedic disorders, diagnosis of herniated disk, low back pain in the last 6 months, and body mass index (BMI) lower than 20 Kg/cm2 or higher than 30 Kg/cm2, commonly accepted contraindications to invasive phsyiotherapist technique including chronic joint disease, surgery, prosthesis or osteosynthesis in the area of intervention, cardiac disease, neoplasia, coagulopathy, and use of certain drugs (fluoroquinoles, anticoagulants, corticosteroids or non-steroidal anti-inflammatories), any contraindications to needling per se including unsurmountable fear of needles, history of adverse reaction to needling, immunocompromise, difficulty expressing feelings appropriately and/or allergy to metals, and epilepsy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using dice-rolling
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
26/06/2017
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Actual
26/06/2017
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Date of last participant enrolment
Anticipated
28/07/2017
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Actual
28/07/2017
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Date of last data collection
Anticipated
28/07/2017
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Actual
28/07/2017
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Sample size
Target
120
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Accrual to date
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Final
80
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Recruitment outside Australia
Country [1]
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Spain
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State/province [1]
8878
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Seville
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Seville
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Address [1]
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Avicena street, s/n, 41009, Seville, Spain
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Country [1]
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Spain
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Primary sponsor type
University
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Name
University of Seville
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Address
Avicena street, s/n, 41009, Seville, Spain
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Country
Spain
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
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None
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Country [1]
295311
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University Hospital Virgen Macarena-Virgen del Rocio.
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Ethics committee address [1]
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Dr. Fedriani, Street 3, 41009 Seville, Spain
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Ethics committee country [1]
297606
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Spain
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Date submitted for ethics approval [1]
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02/02/2017
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Approval date [1]
297606
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12/05/2017
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Ethics approval number [1]
297606
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Summary
Brief summary
Injuries to the hamstring musculature are commonplace in many mainstream sports and occupations involving physical activity. Many predisposing factors for hamstring injury have been suggested within the literature, including insufficient warm- up, poor flexibility, muscle imbalances, neural tension, fatigue. Inadequate flexibility within the posterior thigh compartment appears to be one of the more commonly accepted causes of hamstring injuries. There are several studies in which manual therapy is applied to improve the flexibility of the hamstrings: stretching, eccentric exercises; and/or neural therapy. All these procedures caused a short-term increase in hamstring flexibility. Stretching and eccentric exercises are local and homolateral therapy. However, we believe that neural therapy may be local but have a distant effect. Therefore, the aim of this study will be to examine the immediate effects of a technique of hamstring stretching, neurodynamic sciatic sliding, percutaneous electric stimulation and mechanical stimulation with needle on sciatic nerve in asymptomatic subjects with short hamstrings syndrome. We hypothesized that the classical stretching technique would improve the homolateral range of motion, as assessed by the passive straight leg elevation test (SLR), while sliding neural techniques would lead to short-term bilateral improvement. Muscle activity could be affected.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Blanca De la Cruz Torres
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Address
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Avicena street, s/n, 41009, Seville, Spain
Department of Physical Therapy
University of Seville
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Country
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Spain
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Phone
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+34 666676870
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
74567
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Blanca De la Cruz Torres
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Address
74567
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Avicena street, s/n, 41009, Seville, Spain
Department of Physical Therapy
University of Seville
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Country
74567
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Spain
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Phone
74567
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+34 666676870
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Fax
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Email
74567
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[email protected]
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Contact person for scientific queries
Name
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Blanca De la Cruz Torres
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Address
74568
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Avicena street, s/n, 41009, Seville, Spain
Department of Physical Therapy
University of Seville
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Country
74568
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Spain
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Phone
74568
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+34 666676870
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Fax
74568
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Email
74568
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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