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Not yet recruitingNCT07558993MIRROR-LRUpdated Apr 30, 2026

Mirror Image Spine Correction Exercises Versus Conservative Physiotherapy for Lumbar Radiculopathy

An interventional study of Mirror Image Spine Correction Exercises and Conservative Physiotherapy in Radiculopathy, Radiculopathy Lumbar and Sciatica, sponsored by University of Sharjah. Not yet recruiting at 1 site in United Arab Emirates. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-30.

Sponsored by University of Sharjah · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
64
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Lumbar radiculopathy is a common condition caused by irritation or compression of a lumbar nerve root, often resulting in radiating leg pain, numbness, weakness, and functional limitation. Conservative physiotherapy is commonly used as first-line treatment, but outcomes vary among patients.

This randomized controlled trial will compare Mirror Image Spine Correction Exercises with standardized conservative physiotherapy in adults with lumbar radiculopathy. Participants will be randomly assigned to one of two treatment groups for 12 weeks.

The primary outcome is lumbar nerve root microstructural integrity measured using Diffusion Tensor Imaging (DTI), including Fractional Anisotropy and other diffusion parameters. Secondary outcomes include pain intensity, disability, spinal alignment, and adverse events.

The purpose of this study is to determine whether a targeted posture-correction exercise approach provides greater improvement than conventional physiotherapy.

Read the detailed description

Lumbar radiculopathy is a neuromusculoskeletal disorder commonly caused by lumbar disc herniation or foraminal stenosis leading to nerve root irritation or compression. Symptoms commonly include radiating leg pain, paresthesia, weakness, altered reflexes, and reduced physical function.

Conservative physiotherapy is recommended as first-line management and may include education, graded exercise, mobility restoration, strengthening, neural mobilization, and symptom management. However, treatment response is heterogeneous, and many patients continue to experience persistent symptoms.

Most previous rehabilitation studies have relied primarily on patient-reported outcomes such as pain and disability. These measures are clinically important but may not fully reflect biological recovery of the affected nerve root.

Diffusion Tensor Imaging (DTI) is an advanced magnetic resonance imaging technique that can quantify neural tissue microstructure. Parameters such as Fractional Anisotropy (FA), Mean Diffusivity (MD), Axial Diffusivity (AD), and Radial Diffusivity (RD) may provide objective markers of nerve recovery.

Mirror Image Spine Correction Exercises are individualized posture-based exercises designed to move the trunk or pelvis opposite to identified alignment deviations. This approach may improve biomechanics, reduce abnormal loading, and decrease neural irritation.

This study is a prospective randomized, parallel-group, superiority trial. Eligible adults with unilateral lumbar radiculopathy will be randomly allocated in a 1:1 ratio to:

Mirror Image Spine Correction Exercise group Standardized Conservative Physiotherapy group Both groups will receive supervised treatment sessions three times per week for 12 weeks.

Primary Outcome:

Change in lumbar nerve root microstructural integrity measured by DTI at baseline and week 12.

Secondary Outcomes:

Pain intensity Disability (Oswestry Disability Index) Spinal alignment Safety outcomes and adverse events The study aims to determine whether Mirror Image Spine Correction Exercises produce superior clinical and imaging outcomes compared with conservative physiotherapy.

02

Conditions studied

  • Radiculopathy
  • Radiculopathy Lumbar
  • Sciatica
  • Disc Disease Lumbar

Keywords

  • Mirror Image Exercise
  • Physiotherapy
  • Diffusion Tensor Imaging
  • DTI
  • Conservative Physiotherapy
  • Low Back Pain
  • Nerve Root Compression
  • Postural Correction
  • Randomized Controlled Trial
  • Rehabilitation
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adults aged 18 years or older. Clinical diagnosis of unilateral lumbar radiculopathy. Presence of at least two of the following: dermatomal radiating leg pain, neurological deficit, positive neural tension test.

MRI-confirmed lumbar nerve root compression or irritation consistent with symptoms.

Pain intensity of 3/10 or greater. Able to undergo MRI and Diffusion Tensor Imaging (DTI). Able to understand study procedures and provide written informed consent.

Exclusion criteria

Exclusion Criteria:

  • Previous lumbar spine surgery. Bilateral radiculopathy or unclear diagnosis. Tumor, infection, fracture, inflammatory spinal disease, or cauda equina syndrome.

Severe progressive neurological deficit requiring urgent treatment. Contraindications to MRI (pacemaker, incompatible implants, severe claustrophobia).

Recent lumbar injections or surgery. Other neurological or musculoskeletal disorders affecting outcomes. Pregnancy if MRI contraindicated by local policy. Cognitive impairment or inability to follow instructions.

04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
64 participants (estimated)

Study arms

  • Experimental
    Mirror Image Spine Correction Exercises

    Participants will receive a supervised individualized Mirror Image Spine Correction Exercise program three sessions per week for 12 weeks. Exercises will be based on postural alignment findings and include a prescribed home exercise program.

    Behavioral: Mirror Image Spine Correction Exercises

  • Active comparator
    Conservative Physiotherapy

    Participants will receive standardized conservative physiotherapy three sessions per week for 12 weeks including education, graded exercise, mobility training, strengthening, and clinically indicated adjunctive techniques.

    Behavioral: Conservative Physiotherapy

Interventions

  • BehavioralMirror Image Spine Correction Exercises

    Participants will receive an individualized supervised exercise program based on identified postural alignment deviations. Treatment will be delivered three sessions per week for 12 weeks and may include trunk and pelvic corrective movements, mobility, stabilization, and a prescribed home exercise program.

  • BehavioralConservative Physiotherapy

    Participants will receive standardized conservative physiotherapy three sessions per week for 12 weeks including education, graded exercise, mobility exercises, strengthening, neural mobilization, and clinically indicated adjunctive non-invasive techniques.

05

What researchers measure

Primary outcomes

  1. Lumbar Nerve Root Fractional Anisotropy

    Change in lumbar nerve root microstructural integrity measured using Diffusion Tensor Imaging (DTI) Fractional Anisotropy.

    Time frame: Baseline and Week 12

Secondary outcomes

  1. Pain Intensity

    Measured using Numeric Pain Rating Scale (0-10).

    Time frame: Baseline and Week 12

  2. Spinal Alignment

    Measured using digital posture analysis.

    Time frame: Baseline and Week 12

  3. Additional DTI Parameters

    Mean Diffusivity, Axial Diffusivity, and Radial Diffusivity.

    Time frame: Baseline and Week 12

06

Study locations

1 site
  • Al Qassimi Hospital
    Sharjah city, Emirate of Sharjah, United Arab Emirates
    • fatima A Alowais, PT · Contact · fatimaalowais7@gmail.com · +971566663372
    • Tamer shousha, PhD · Contact · tshousha@sharjah.ac.ae · +971562224469
    • Tamer Shousha, Phd · Principal investigator
    • fatima Alowais, PT · Sub investigator
07

References and documents

Publications

  • Tarulli AW, Raynor EM. Lumbosacral radiculopathy. Neurol Clin. 2007 May;25(2):387-405. doi: 10.1016/j.ncl.2007.01.008. PubMed 17445735 ↗
  • Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin. 2007 May;25(2):353-71. doi: 10.1016/j.ncl.2007.01.004. PubMed 17445733 ↗

Individual participant data

Plan to share: Yes — De-identified individual participant data may be shared upon reasonable request after publication, subject to ethics approval, institutional policy, and participant confidentiality protections.

Supporting information: Study protocol, Sap, Icf, Analytic code

08

Registry details

Key details

Study ID
NCT07558993
Lead sponsor
University of Sharjah
Responsible party
Fatima Alowais (Associate Professor, Department of Physiotherapy, Principal Investigator, University of Sharjah) — Principal investigator
First posted
Apr 30, 2026
Start date
Sep 1, 2026 (estimated)
Primary completion
Aug 31, 2027 (estimated)
Completion
Sep 30, 2027 (estimated)
Last update
Apr 30, 2026

Study contacts

Fatima A Alowais, PT
Contact
fatimaalowais7@gmail.com
+971566663372
Tamer shousha, PhD
Contact
tshousha@sharjah.ac.ae
+971562224469

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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