Neurodynamic exercises provide no additional benefit to extension-oriented exercises in people with chronic low back-related leg pain and a directional preference: A randomized clinical trial |
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| Affiliation: | 1. Graduate Program in Physical Education, Federal University of Sergipe, São Cristovão, Sergipe, Brazil;2. Department of Physical Therapy, Federal University of Sergipe, São Cristovão, Sergipe, Brazil;1. Regis University, Health & Exercise Science Program, School of Physical Therapy, Denver, CO, 80221, USA;2. Washington State University, Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Spokane, WA 99202, USA;1. Biomechanics Laboratory, Universidade Federal de Santa Maria, Centro de Educação Física e Desportos, Santa Maria, RS, Brazil;2. Applied Neuromechanics Research Group, Universidade Federal do Pampa, Uruguaiana, RS, Brazil;3. La Trobe University - Rural Health School, Bendigo, Vic, Australia;4. Biomechanics and Kinesiology Research Group, Universidade Federal do Rio Grande do Sul, Escola de Educação Física, Fisioterapia e Dança, Porto Alegre, RS, Brazil;1. Lato Sensu Postgraduate Program in Strength Training, Universidade Federal do Rio de Janeiro, Brazil;2. Kinesiology Research Group Applied to Strength Training, São José University Center, RJ, Brazil;3. Kinesiology and Performance Center (NUCAR) - Biodesp Institute, Rio de Janeiro, RJ, Brazil;4. Laboratory of Exercise and Sport, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil;5. Postgraduate Program in Exercise and Sport Sciences, Institute of Physical Education and Sports, Rio de Janeiro State University, RJ, Brazil;6. Health and Human Performance Department, Montana State University Billings, Billings, MT, USA;7. LADTEF - Performance, Training, and Physical Exercise Laboratory, Universidade Federal do Rio de Janeiro, Brazil;1. Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey;2. Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey;3. Department of Therapy and Rehabilitation, Vocational School of Health Services, Karamanoğlu Mehmet Bey University, Karaman, Turkey;1. Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil;2. Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil;3. Department of Physiotherapy, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, BH, Brazil |
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| Abstract: | BackgroundChronic low back-related leg pain may involve mixed pain mechanisms. A strategy to address both neuropathic and nociceptive pain symptoms would be combining treatments.ObjectiveTo assess the effects of adding neurodynamic exercises to extension-oriented exercises in patients with chronic low back-related leg pain and a directional preference.DesignTwo arm, single blind, randomized clinical trial.MethodEligible participants were aged between 18 and 65 years, had low back pain radiating below gluteus for at least 3 months, pain intensity greater than 3 points in the numerical pain rating scale, positive SLR test and a directional preference for lumbar extension movements. Thirty-one participants were randomly allocated into one of two groups: extension-oriented exercises (EE) or extension exercises plus neurodynamic exercises (EEN). Primary outcomes were leg pain intensity and function at 3 weeks. Secondary outcomes were low back pain intensity, disability, global perceived effect and quality of life at 3 weeks and at 1 month.ResultsRetention rate was 100% (n = 14) in EE and 94% (n = 16) in EEN for primary outcome analysis. There was no between-group difference for the primary outcomes and for low back pain intensity, GPE and quality of life at 3 weeks. For some outcomes, EE was superior to EEN.ConclusionsWe found no benefits in adding neurodynamic exercises to extension-oriented exercises for patients with nerve-related leg pain and a directional preference. As this study has a small and very specific sample, results may be interpreted with caution. |
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| Keywords: | Chronic pain Exercise therapy Sciatica Low back pain |
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