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Trial registered on ANZCTR
Registration number
ACTRN12620001367932
Ethics application status
Approved
Date submitted
1/02/2020
Date registered
18/12/2020
Date last updated
18/12/2020
Date data sharing statement initially provided
18/12/2020
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effect of nerve mobilization techniques and spinal traction in patients with back pain radiating into lower limbs
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Scientific title
Effectiveness of neural mobilization with traction in the management of lumbar radiculopathy (ENMT Trial)
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Secondary ID [1]
300233
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Nil Known
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Universal Trial Number (UTN)
U1111-1247-0631
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Trial acronym
ENMT Trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Lumbar Radiculopathy
315945
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Condition category
Condition code
Neurological
314213
314213
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Neural Mobilization plus Lumbar Traction arm: participants in this group received 12 sessions of lumbar spine traction for up to 12 days followed by neural mobilizations. Traction was applied for 20 minutes duration with an intermittent force of 50 per cent of body weight. Each participant also received two types of mobilizing techniques: Static opener and two-end sliders. For applying static opener participants were instructed to lie on their side with painful side uppermost and hips and knee were flexed to 90, they were requested to move towards the edge of the treatment bed so that their knees protrude forward hand’s breadth over the side of the plinth. Then participants were advised to slowly drape their legs over the edge of the bed hence producing contralateral lateral flexion on the symptomatic side. They held this position for up to 1 minute and repeat it thrice during each session. For administering two-ended slider patients were instructed to sit straight on the treatment table with their legs hanging and holding arms at their back. For the first slider, they have to flex their neck from neutral position to full flexion simultaneously flexing their both knees. During the second slider, they had to extend their neck from neutral position simultaneously extending their both knees. Each technique was performed 10 times per session. Both types of mobilizing techniques were employed one after another after the application of traction. Treatment was delivered by physiotherapists who had at least 2 years of clinical experience and trained in applying neural mobilizations. Each participant was also required to provide data about their disability level (Oswestry Disability Questionnaire) and pain (Numeric Pain Rating Scale) before first treatment session and one day after the commencement of the last session. Treatment was provided at outpatient physiotherapy facility.
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Intervention code [1]
316609
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Treatment: Other
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Intervention code [2]
316611
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Rehabilitation
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Comparator / control treatment
Lumbar Traction Alone arm: participants in this group received 12 sessions of lumbar spine traction only for up to 12 days. Traction was applied for 20 minutes duration with an intermittent force of 50 per cent of body weight. Treatment was delivered individually to each participant by physiotherapists who had at least 2 years of clinical experience. Each participant was also required to provide data about their disability level (Oswestry Disability Questionnaire) and pain (Numeric Pain Rating Scale) before first treatment session and one day after the commencement of the last session. Treatment was provided at outpatient physiotherapy facility.
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Control group
Active
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Outcomes
Primary outcome [1]
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Mean Disability Score assessed using the Oswestry Disability Index (ODI)
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Assessment method [1]
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Timepoint [1]
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Baseline and next day post commencement of the intervention
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Primary outcome [2]
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Radiating Lumbar Pain assessed using 11-point Numerical Pain Rating Scale (NPRS)
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Assessment method [2]
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Timepoint [2]
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Baseline and next day post commencement of the intervention
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Secondary outcome [1]
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Nil
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Assessment method [1]
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Timepoint [1]
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Nil
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Eligibility
Key inclusion criteria
*Participants between 20 and 70 years of age.
*Participants with a chief complaint of low back pain referred for physical therapy.
*Participants having pain radiating below the gluteal fold which reproduced radicular symptoms on Straight Leg Raise (SLR) test, Slump test, or Prone Knee Bend Test
*Participants having Oswestry Index score of greater than 10% at baseline.
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Minimum age
20
Years
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Maximum age
70
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
*Patients presenting with spinal conditions (e.g. infection, tumours, fractures, or osteoporosis)
*Patients who are pregnant.
*Patients with a history of previous spinal surgery.
*Patients with symptoms of Cauda Equina Syndrome.
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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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
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Actual
3/07/2019
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Date of last participant enrolment
Anticipated
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Actual
29/10/2019
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Date of last data collection
Anticipated
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Actual
13/11/2019
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Sample size
Target
50
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Accrual to date
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Final
50
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Recruitment outside Australia
Country [1]
22252
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Pakistan
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State/province [1]
22252
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Sind
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Funding & Sponsors
Funding source category [1]
304663
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Self funded/Unfunded
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Name [1]
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Muhammad Saad Khan
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Address [1]
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College of Physiotherapy, Jinnah Postgraduate Medical Centre, Rafiqui Sarwar Shaheed Road, Karachi Cantonment, Karachi, Sindh 75510
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Country [1]
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Pakistan
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Funding source category [2]
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Hospital
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Name [2]
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Jinnah Postgraduate Medical Centre (JPMC)
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Address [2]
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Rafiqui Sarwar Shaheed Road, Karachi Cantonment, Karachi, Sindh 75510
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Country [2]
305275
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Pakistan
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Primary sponsor type
Individual
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Name
Muhammad Saad Khan
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Address
College of Physiotherapy, Jinnah Postgraduate Medical Centre, Rafiqui Sarwar Shaheed Road, Karachi Cantonment, Karachi, Sindh 75510
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Country
Pakistan
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
304967
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Country [1]
304967
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305083
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Institutional Ethical Review Committee of Isra Institute of Rehabilitation Sciences, Isra University, Karachi Campus
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Ethics committee address [1]
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C-8, Block 14, Gulistan-e-Johar, Karachi, Karachi City, Sindh 75300, Pakistan
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Ethics committee country [1]
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Pakistan
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Date submitted for ethics approval [1]
305083
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Approval date [1]
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01/11/2018
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Ethics approval number [1]
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IERC/IIRS-IU-KC/18
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Summary
Brief summary
Neural mobilizations (also called Neurodynamics) are a group of techniques in manual therapy which are used to mobilize nerves; these techniques are shown to be effective in conditions like Radiculopathy. Currently, mechanical traction is a widely used method for the treatment of Lumbar Radiculopathy. This study aimed to investigate the effectiveness of neural mobilization techniques with mechanical traction in the management of patients with lumbar Radiculopathy. The study was a randomised controlled trial. Data were collected from outpatient physiotherapy facility. The sample consisted of 50 participants with Lumbar Radiculopathy who were randomized into two groups. Twenty-five patients underwent 12 sessions of lumbar traction with neurodynamics and 25 underwent 12 sessions of lumbar traction only. The outcome measures were the Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS). These measures were applied both at baseline and discharge.
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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 Muhammad Saad Khan
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Address
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College of Physiotherapy, Jinnah Postgraduate Medical Centre, Rafiqui Sarwar Shaheed Rd, Karachi Cantonment, Karachi, Sindh 75510
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Country
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Pakistan
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Phone
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+922199201300
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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
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Muhammad Saad Khan
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Address
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College of Physiotherapy, Jinnah Postgraduate Medical Centre, Rafiqui Sarwar Shaheed Rd, Karachi Cantonment, Karachi, Sindh 75510
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Country
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Pakistan
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Phone
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+922199201300
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Muhammad Saad Khan
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Address
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College of Physiotherapy, Jinnah Postgraduate Medical Centre, Rafiqui Sarwar Shaheed Rd, Karachi Cantonment, Karachi, Sindh 75510
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Country
99212
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Pakistan
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Phone
99212
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+922199201300
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Fax
99212
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Email
99212
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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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