An interventional study of exercise and Cox flexion-distraction therapy in Lumbar Disc Herniation, sponsored by Istanbul Medipol University Hospital. Completed at 2 sites in Turkey (Türkiye). Open to participants aged 30 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-10-29.
Sponsored by Istanbul Medipol University Hospital · Not applicable, Interventional, and Treatment
Among 121 studies in Intervertebral Disc Displacement with a site in Turkey — 24 open to participants now, 30 under way, none of them phase 3. Intervertebral Disc Displacement · Turkey.
Among the 121 studies in Intervertebral Disc Displacement with a site in Turkey, this one is the 32nd largest by enrollment of the 86 interventional ones, is one of 18 that started in 2025, is one of 85 with no phase, and was the 78th registered.
474 studies on the registry are indexed under Intervertebral Disc Displacement; 100 are open to participants now.
This study's enrollment of 68 is close to the median of 63 across 344 interventional studies indexed under Intervertebral Disc Displacement.
Browse Intervertebral Disc Displacement studies →24 of the 121 studies in Intervertebral Disc Displacement with a site in Turkey are open now, in 1 country. Each count lists the studies.
Of the 50 Intervertebral Disc Displacement studies recruiting now, 20 (40%) set no upper age limit and 26 (52%) stop at 75 or younger; 3 take children under 18; 6 take healthy volunteers.
This study: 30 Years to 60 Years · all sexes · no healthy volunteers.
The full table on the hub →121 studies; the count open now beside each. This study's row is marked.
First in 2018; this study’s year is marked. 18 started in 2025.
Median enrollment 60 across the 86 interventional studies, 78 across the 35 observational. Of the 80 that completed or were terminated, 0 (0%) have results posted.
None of the 121 has an industry lead sponsor. The 10 most frequent:
Istanbul Medipol University Hospital is the lead sponsor of 366 studies on the registry; 46 are open to participants now.
Istanbul Medipol University Hospital has 3 studies filed under Intervertebral Disc Displacement — fewer than ten, so there is no comparison to draw.
7 of the studies in Intervertebral Disc Displacement with a site in Turkey that are under way reach primary completion within a year, 0 of them phase 3. Phase 3 first, then by date:
| Study | Primary completion |
|---|---|
| NCT07614555Ankara Etlik City HospitalFlow-Controlled Versus Volume-Controlled Ventilation in Lumbar Disc Herniation Surgery | 2026-11-12 |
| NCT07550569Baskent UniversityEffectiveness of High Intensity Laser Therapy in Management of Lumbar Disc Herniation | 2026-11-30 |
| NCT07750418Vezirköprü State HospitalComparison of TLIP Block and QIP Block for Postoperative Analgesia After Lumbar Spine Surgery | 2026-12-31 |
| NCT07862257Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research HospitalPulmonary Mechanics and Cerebral Oxygenation During Prone Lumbar Disc Surgery | 2027-01-30 |
| NCT07400068Mersin UniversityPLDD With or Without Transforaminal Epidural Steroid Injection in Lumbar Disc Herniation | 2027-04-01 |
Among the 121 studies in Intervertebral Disc Displacement with a site in Turkey, from their registry updates:
This prospective, two-center, non-randomized controlled study compared the effects of conventional physical therapy (CPT) and Cox flexion-distraction therapy (CFT) on pain, lumbar range of motion, disability, and health-related quality of life in patients with lumbar disc herniation (LDH).
The study included adults aged 30-60 years diagnosed with L4-L5 lumbar disc herniation who received treatment at Bursa VM Medical Park Hospital or Nilüfer Spine Health Center in Türkiye. Participants were allocated to treatment groups according to their preferred treatment centers, without randomization.
A total of 68 participants were enrolled, and 66 were included in the final analysis (32 in the CFT group and 34 in the CPT group). Both groups received treatment three times per week for four weeks.
The CPT group received therapeutic ultrasound, transcutaneous electrical nerve stimulation (TENS), superficial heat application, and home exercises. The CFT group received Cox flexion-distraction therapy, superficial heat application, and home exercises.
Pain intensity was assessed using the Visual Analog Scale (VAS), disability using the Oswestry Disability Index (ODI), lumbar range of motion using a standard goniometer, and health-related quality of life using the Short Form-36 Health Survey (SF-36).
The study evaluated clinical outcomes associated with these two conservative treatment approaches, taking into account the non-randomized nature of treatment allocation.
This prospective, two-center, non-randomized controlled study compared the effects of conventional physical therapy (CPT) and Cox flexion-distraction therapy (CFT) on pain, lumbar range of motion, disability, and quality of life in patients with lumbar disc herniation (LDH).
The study was conducted at Bursa VM Medical Park Hospital and Nilüfer Spine Health Center in Türkiye. Participants aged 30-60 years with a diagnosis of L4-L5 lumbar disc herniation were recruited from these two centers.
Treatment allocation was determined by participants' preferred treatment centers rather than by a random allocation procedure. Participants receiving treatment at Bursa VM Medical Park Hospital constituted the conventional physical therapy group, whereas participants treated at Nilüfer Spine Health Center constituted the Cox flexion-distraction therapy group. No individual randomization was performed.
A total of 68 participants were initially enrolled, with 34 participants in each treatment group. The final analysis included 66 participants (32 in the CFT group and 34 in the CPT group).
The conventional physical therapy group received therapeutic ultrasound, transcutaneous electrical nerve stimulation (TENS), superficial heat application, and home exercises. The Cox flexion-distraction therapy group received Cox flexion-distraction treatment, superficial heat application, and home exercises. Both groups underwent treatment three times per week for four weeks.
Pain intensity was assessed using the Visual Analog Scale (VAS), disability using the Oswestry Disability Index (ODI), health-related quality of life using the Short Form-36 Health Survey (SF-36), and lumbar range of motion using a standard goniometer. Assessments were performed before and after the intervention period.
Statistical analyses included baseline-adjusted analysis of covariance (ANCOVA) to evaluate between-group differences, together with appropriate supplementary non-parametric analyses. The Benjamini-Hochberg false discovery rate procedure was applied to account for multiple comparisons.
The study aimed to evaluate differences in clinical outcomes between Cox flexion-distraction therapy and conventional physical therapy while acknowledging the limitations associated with non-randomized, preference-based treatment allocation.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Participants treated at Bursa VM Medical Park Hospital received a conventional physical therapy programme comprising therapeutic ultrasound, transcutaneous electrical nerve stimulation (TENS), hot-pack application, and therapeutic exercises. Therapeutic ultrasound was applied to the right and left sides of the affected lumbar region for 4 min on each side. TENS was administered at a frequency of 100 Hz for 20 min, with the stimulation intensity adjusted to a comfortable sensory level perceived by the participant. A hot pack wrapped in a towel was applied over the lumbar region for 15 min. Participants additionally performed a therapeutic exercise programme including pelvic tilt, hip-flexor stretching, hamstring stretching, cat-camel exercises, bridging, and straight-leg-raise exercises. Each exercise was performed for 10 repetitions. The treatment programme was administered three times per week for four consecutive weeks, resulting in a total of 12 treatment sessions.
Other: exercise · Other: Cox flexion-distraction therapy
Participants received Cox flexion-distraction therapy, hot-pack application, and therapeutic exercises. Cox therapy was performed on a specialized table in the prone position for approximately 10 minutes per session. Flexion-distraction was applied in sets of five slow cycles, with 3-5 sets per symptomatic segment and 20-30 seconds of rest between sets. Distraction was progressively adjusted according to patient tolerance. A hot pack was applied to the lumbar region for 15 minutes. Exercises included pelvic tilt, hip-flexor and hamstring stretching, cat-camel, bridging, and straight-leg raises, each performed for 10 repetitions. Treatment was administered three times weekly for four weeks (12 sessions).
Other: Cox flexion-distraction therapy
Participants in both treatment groups performed the same therapeutic exercise programme, including pelvic tilt, hip-flexor stretching, hamstring stretching, cat-camel exercises, bridging, and straight-leg-raise exercises. Each exercise was performed for 10 repetitions. The programme was administered alongside the group-specific interventions three times per week for four weeks (12 sessions).
Cox flexion-distraction therapy was performed on a specialized table with participants in the prone position. Controlled flexion-distraction movements were applied to the lumbar spine in sets of five slow cycles, with 3-5 sets per symptomatic segment and 20-30 seconds of rest between sets. The distraction distance was progressively adjusted according to participant tolerance. Each session included approximately 10 minutes of Cox therapy, 15 minutes of hot-pack application, and therapeutic exercises. Treatment was administered three times per week for four weeks (12 sessions).
subjective pain
Measurements will be taken in two ways: Visual Analog Scale (VAS): The VAS scale will be used to assess low back pain in individuals with LDH. Participants will mark their pain level on a 10 cm line, where 0 represents "no pain" and 10 represents "very severe pain".
Time frame: through study completion, an average of 6 months
range of motion
Lumbar range of motion (ROM) was assessed using a standard goniometer in six planes: flexion, extension, right and left lateral flexion, and right and left rotation. Measurements were performed according to the positioning described by Norkin and White, and the mean of three consecutive measurements was recorded for each movement. Assessments were conducted at baseline and after the four-week treatment period. ROM was measured in degrees (°).
Time frame: through study completion, an average of 6 months
Functional capacity
Functional capacity will be evaluated using the Oswestry Disability Index (ODI). The ODI is a questionnaire scale designed to assess the impact of low back pain on daily life. It consists of 10 items, each scored from 0 to 5. The total score reflects the patient's functional capacity. The ODI is a widely used and highly valid scale for evaluating the functional status of patients with low back pain
Time frame: through study completion, an average of 6 months
Daily living activities
Daily living activities will be evaluated using the SF-36 Quality of Life Scale. The SF-36 is a questionnaire designed to assess individuals' overall health status and quality of life, covering both physical and mental health dimensions. It consists of 36 questions, and separate scores are calculated for each dimension. The SF-36 is widely used for quality of life assessment in various populations, and its reliability and validity have been well-established.
Time frame: through study completion, an average of 6 months
Ran from Apr 2025 to primary completion in Jan 2026, 9 months.
Of 178 non-industry interventional studies with no phase under Intervertebral Disc Displacement, half reached primary completion within 11 months of starting (the median), counting those still running; a quarter within 5 and three quarters within 23. This study's 9 months is below that.
Counting every sponsor, half of 191 studies reached it within 12 months; a quarter within 5 and three quarters within 27.
Since we started tracking on Sep 25, 2026, the dates moved once, on Oct 29, 2026: primary completion Apr 2026 → Jan 2026 and completion May 2026 → Jan 2026.
Earlier changes are on the record history on ClinicalTrials.gov ↗
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is completed, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
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