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Not yet recruitingNCT07646379Updated Jun 12, 2026

Effects of Spinal Mobilization With Leg Movement With and Without Neural Flossing Technique in Lumbar Radiculopathy

An interventional study of SMWLM along with Neural flossing technique and SMWLM without Neural flossing technique in Lumbar Radiculopathy, sponsored by Riphah International University. Not yet recruiting at 1 site in Pakistan. Open to participants aged 30 Years to 50 Years. Per ClinicalTrials.gov, last updated 2026-06-12.

Sponsored by Riphah International University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Jul 2026, 3 months ago, but the record still lists the study as not yet recruiting.
Phase
Not applicable
Study type
Interventional
Enrollment
36
Allocation
Randomized
Ages
30 Years to 50 Years
Sex
All
01

Study summary

Lumbar radiculopathy is a spinal condition caused by compression or irritation of the lumbar nerve roots, leading to radiating leg pain, sensory changes, and functional disability. It commonly affects middle-aged and older adults, impairing daily activities and quality of life. Conservative treatments include medication, physiotherapy, and exercise. Spinal Mobilization with Leg Movement (SMWLM), a Mulligan technique, uses passive vertebral mobilization with active leg motion to reduce nerve compression and improve mobility. Neural flossing, or neurodynamic mobilization, enhances nerve mobility by promoting gliding of nerve roots, especially in cases of restricted neural movement. This study aims to evaluate the effects of spinal mobilization with leg movement (SMWLM) with and without neural flossing technique on pain, disability, and range of motion in patients with lumbar radiculopathy.

Read the detailed description

This single-blinded randomized clinical trial will be conducted at Noor Al-Shifa Hospital, Lahore, over 10 months following ethical approval. A total of 36 patients (18 in each group) with lumbar radiculopathy will be recruited by using non-probability convenience sampling. Group A will receive spinal mobilization with leg movement (SMWLM) with neural flossing technique, while Group B will receive spinal mobilization with leg movement (SMWLM) only. Each group will undergo treatment 3 times per week for 6 weeks, with each session lasting 45 minutes. Pre- and post-intervention assessments will include pain (NPRS), SLR range of motion (Goniometer), and disability (Modified Oswestry Disability Index). Data will be analyzed using SPSS version 26

02

Conditions studied

  • Lumbar Radiculopathy

Keywords

  • pain, radiculopathy, range of motion, spinal mobilization
03

In context

Radiculopathy

483 studies on the registry are indexed under Radiculopathy; 145 are open to participants now.

This study's planned enrollment of 36 is below the median of 60 across 373 interventional studies indexed under Radiculopathy.

Browse Radiculopathy studies →

Lead sponsor

Riphah International University is the lead sponsor of 2,193 studies on the registry; 650 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
30 Years to 50 Years
Sexes eligible
All
Accepts healthy volunteers
No

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.

Inclusion criteria

    • Patients aged between 30-50 years (9)

      • Both male and female genders
      • Patient should have lower back pain radiating to one side with numbness, tingling, and muscle weakness (12)
      • Positive Lasegue \& slump test

Exclusion criteria

Exclusion Criteria:

  • Any fracture or other injury

    • Any systemic illness
    • Any inflammatory disease (Rheumatoid arthritis, gout)
    • Disc herniation
    • Piriformis syndrome
    • Lumbar instability
    • Scoliosis
05

Study design

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

Study arms

  • Experimental
    SMWLM along with neural flossing technique

    Spinal Mobilization with Leg Movement (SMWLM) and Neural Flossing are highly effective, conservative physical therapy approaches for managing lumbar radiculopathy (sciatica). They aim to reduce nerve root compression, disperse neural edema, and restore the healthy gliding of nerves within their surrounding tissues

    Other: SMWLM along with Neural flossing technique

  • Active comparator
    SMWLM without neural flossing technique

    Spinal Mobilization with Leg Movement (SMWLM) is a manual therapy technique developed by Brian Mulligan to treat lumbar radiculopathy. It combines sustained gliding pressure on the lumbar spine with passive or active straight leg raises to alleviate nerve compression, reduce pain, and restore mobility

    Other: SMWLM without Neural flossing technique

Interventions

  • OtherSMWLM along with Neural flossing technique

    The participant will be positioned in side-lying with limb where the pain radiated to on top. Therapist 1 will stand at the participant's ventral side and apply transverse glide with the thumb on the involved lumbar spinous process. Therapist 2 will then abduct the affected leg by 10° and take the limb gently into hip flexion with knee extended, while the glide will be sustained continuously by therapist 1. The entire motion during mobilization will be maintained pain-free. The participant will be positioned in side-lying with limb where the pain radiated to on top. Therapist 1 will stand at the participant's ventral side and apply transverse glide with the thumb on the involved lumbar spinous process. Therapist 2 will then abduct the affected leg by 10° and take the limb gently into hip flexion with knee extended, while the glide will be sustained continuously by therapist 1. The entire motion during mobilization will be maintained pain-free.

  • OtherSMWLM without Neural flossing technique

    The participant will be positioned in side-lying with limb where the pain radiated to on top. Therapist 1 will stand at the participant's ventral side and apply transverse glide with the thumb on the involved lumbar spinous process. Therapist 2 will then abduct the affected leg by 10° and take the limb gently into hip flexion with knee extended, while the glide will be sustained continuously by therapist 1. The entire motion during mobilization will be maintained pain-free. The procedure will be repeated three times as per Mulligans rule of 3, post which the SLR test and NPRS will be re-measured

06

What researchers measure

Primary outcomes

  1. Numeric Pain Rating Scale for Pain

    It is a widely used subjective measure for assessing pain intensity, where patients rate their pain on a scale from 0 (no pain) to 10 (worst imaginable pain). It has high test-retest reliability (ICC = 0.92) and strong construct validity for acute and chronic musculoskeletal conditions

    Time frame: upto 4 weeks

  2. Goniometer for ROM

    It is a clinical instrument used to measure joint range of motion in degrees, commonly applied in musculoskeletal assessments. It demonstrates excellent intra-rater (ICC = 0.95) and inter-rater reliability (ICC = 0.89), with strong validity when compared with digital motion analysis tools

    Time frame: Upto 4 weeks

  3. Modfied Oswestry Disability Index for disability

    It is a self-reported questionnaire used to assess disability due to low back pain, covering aspects such as pain, mobility, and daily activities. It is a highly valid tool (construct validity r = 0.75) with excellent reliability (Cronbach's alpha = 0.90, ICC = 0.91), making it one of the most commonly used functional outcome measures in spine-related research

    Time frame: Upto 4 weeks

07

Study locations

1 site
  • Physio house (Comprehensive Rehab Center)
    Lahore, Punjab Province 54920, Pakistan
08

References and documents

Publications

  • Soar H, Comer C, Wilby MJ, Baranidharan G. Lumbar radicular pain. BJA Educ. 2022 Sep;22(9):343-349. doi: 10.1016/j.bjae.2022.05.003. Epub 2022 Aug 1. No abstract available. PubMed 36033931 ↗
  • Ali MS, Kelini KIS, Elsayed M, Galal DOSM, Abdul-Rahman RS. Prevalence of lumbosacral radiculopathy among physiotherapists of pediatric rehabilitation. Revista iberoamericana de psicología del ejercicio y el deporte. 2024;19(2):184-8.
  • Bateman EA, Fortin CD, Guo M. Musculoskeletal mimics of lumbosacral radiculopathy. Muscle Nerve. 2025 May;71(5):816-832. doi: 10.1002/mus.28106. Epub 2024 May 10. PubMed 38726566 ↗
  • Pinto MV, Ng PS, Laughlin RS, Thapa P, Aragon Pinto C, Shelly S, Shouman K, Dyck PJ, Dyck PJB. Risk factors for lumbosacral radiculoplexus neuropathy. Muscle Nerve. 2022 May;65(5):593-598. doi: 10.1002/mus.27484. Epub 2022 Jan 22. PubMed 34970748 ↗
  • Hincapie CA, Kroismayr D, Hofstetter L, Kurmann A, Cancelliere C, Raja Rampersaud Y, Boyle E, Tomlinson GA, Jadad AR, Hartvigsen J, Cote P, Cassidy JD. Incidence of and risk factors for lumbar disc herniation with radiculopathy in adults: a systematic review. Eur Spine J. 2025 Jan;34(1):263-294. doi: 10.1007/s00586-024-08528-8. Epub 2024 Oct 25. PubMed 39453541 ↗
  • Price MR, Mead KE, Cowell DM, Troutner AM, Barton TE, Walters SA, Daniels CJ. Medication recommendations for treatment of lumbosacral radiculopathy: A systematic review of clinical practice guidelines. PM R. 2024 Oct;16(10):1128-1142. doi: 10.1002/pmrj.13142. Epub 2024 Apr 17. PubMed 38629664 ↗
  • Amjad F, Mohseni-Bandpei MA, Gilani SA, Ahmad A, Hanif A. Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord. 2022 Mar 16;23(1):255. doi: 10.1186/s12891-022-05196-x. PubMed 35296293 ↗
  • Wang S, Hebert JJ, Abraham E, Vandewint A, Bigney E, Richardson E, El-Mughayyar D, Attabib N, Wedderkopp N, Kingwell S, Soroceanu A, Weber MH, Hall H, Finkelstein J, Bailey CS, Thomas K, Nataraj A, Paquet J, Johnson MG, Fisher C, Rampersaud YR, Dea N, Small C, Manson N. Postoperative recovery patterns following discectomy surgery in patients with lumbar radiculopathy. Sci Rep. 2022 Jul 1;12(1):11146. doi: 10.1038/s41598-022-15169-8. PubMed 35778472 ↗
  • Kim SJ, Jang HY, Lee S-M. Effects of spinal mobilization with leg movement and neural mobilization on pain, mobility, and psychosocial functioning of patients with lumbar disc herniation: A randomized controlled study. Physical Therapy Rehabilitation Science. 2023;12(2):92-104.
  • Rakesh R. Effectiveness of Mckenzie Exercises Versus Neural Flossing Technique in Patients with Lumbar Radiculopathy. Indian Journal of Physiotherapy & Occupational Therapy. 2024;18.
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for May 2026; primary completion for Jul 2026, 2 months later.

Of 203 non-industry interventional studies with no phase under Radiculopathy, half reached primary completion within 11 months of starting (the median), counting those still running; a quarter within 5 and three quarters within 30. This study's planned 2 months is below that.

Counting every sponsor, half of 215 studies reached it within 12 months; a quarter within 5 and three quarters within 45.

How these figures are worked out, and which studies are left out of them.

Registered
Jun 8, 2026
First posted
Jun 12, 2026
StartEst.
May 30, 2026
Primary completionEst.
Jul 30, 2026
CompletionEst.
Aug 30, 2026
Last update
Jun 12, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 12, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07646379
Responsible party
Sponsor
First posted
Jun 12, 2026
Start date
May 30, 2026 (estimated)
Primary completion
Jul 30, 2026 (estimated)
Completion
Aug 30, 2026 (estimated)
Last update
Jun 12, 2026

Study contacts

Samrood Akram, PhD*
Contact
samrood.akram@riphah.edu.pk
03324806143
Rahat Afzal, MS-OMPT
principal investigator · Governement Teaching Hospital Shahdara Lahore.

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.

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