Lumbar radiculopathy is a neuromusculoskeletal condition that is characterized as radiating pain in the leg described as electric, burning, or sharp, and is associated with dermatomal or myotomal differences and tendon reflex abnormalities. Neural mobilization is a manual therapy technique designed to alleviate nerve pain and dysfunction by gently mobilizing the nerve along its pathway. The Progressive Inhibition of Neuromuscular Structures (PINS) technique is a therapeutic approach that aims to reduce pain and muscle tension by sequentially applying pressure to specific points along a muscle or nerve pathway. This study focuses on pain, range of motion and disability with these techniques in patients with lumbar radiculopathy.
Age group between 18 and 40 years(.
Both gender male and female.
Participants diagnosed as having a chronic (lasting three months or longer) lumbar radiculopathy.
Diagnosed patient of having radiculopathy at level of L4-L5 and L5-S1 lesion (unilateral radiculopathy).
Individuals having bilateral lumbar radiculopathy.
Spondylolysis/spondylolisthesis
Mechanical systemic low back pain or neoplasmic and infectious processes.
Participants with severe nerve root compression (non-ambulant/wheelchair-bound).
Parallel
Progressive Inhibition of Neuromuscular Structure
Other interventionThe index fingers of both hands were used to palpate two connected locations, referred to as main and endpoints. The locations were located along a neuromuscular structure and were the most and least sensitive sections, respectively. Once an endpoint (region of least sensitivity) was identified, the index finger of one hand was used to provide a moderate ischemia compression; the pressure was kept constant until the course of therapy was finished. After identifying the primary point-the area of greatest sensitivity-a moderate ischemic compression was also applied for 30 seconds using the index finger of the other hand.
Neural Tissue Mobilization.
Other interventionThe patient sat well back on the end of a plinth with thighs fully supported. The patient was asked to slump. Overpressure was applied to the lumbar and thoracic flexion in attempt to bow the spine rather than the hips. With spinal flexion position maintained, the patient was asked to bend his chin to chest and then overpressure in the same direction was added. The patient was asked to extend his knee actively. The patient was asked to dorsiflex his ankle. The therapist was maintaining the ankle dorsiflexion as a progression for technique. The number of these sequences was repeated several times,through which the amplitude of the technique was increased according to the patient response. The technique was progressed to a point where symptoms reproduced, or it was taken to a point where resistance of the movement was encountered.
NUMERIC PAIN RATING SCALE (NPRS):
Low back and leg pain were measured using the numeric pain rating scale (NPRS), as has been used in various randomized controlled trials for NE and spinal pain. 41,42,48 The minimal detectable change for the NPRS is reported to be 2.1
OSWESTRY DISABILITY INDEX (ODI):
The ODI assesses the impacts of low back pain or leg pain on the physical function and activities of daily living. It has been shown to have high levels of reliability, validity and responsiveness in patients with low back pain(20). A change of 5 points (10%) has been proposed as the minimal detectable change.
Sciatica Bothersomeness Index (SBI):
This scale was used to assess the level of sciatica among participants. The scale's scores range from 0 to 24, with higher scores reflecting more severe sciatica bothersomeness. This scale has a high level of internal consistency reliability (Cronbach's alpha of 0.70) and test-retest reliability (ICC of 0.90); a change of 6.5 points is considered clinically significant
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