Effects of spinal manipulation or mobilization as an adjunct to neurodynamic mobilization for lumbar disc herniation with radiculopathy: a randomized clinical trial.

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研究概要

Forty patients with chronic lumbar disc herniation with radiculopathy were randomized to receive either spinal manipulative therapy (SMT; n=20) or mobilization (MOB; n=20). Both groups received their treatments as adjuncts to neurodynamic mobilization. The primary outcome of interest was pain on a Visual Analog Scale (VAS) and activity limitation using the Roland-Morris Disability Questionnaire (RMDQ) at 12 weeks. Secondary outcomes included VAS back pain, VAS leg pain, Timed Up and Go (TUG) test, sciatica index, Short-Form Health Survey (SF-36), and Global Rating of Change (GROC), assessed at 6, 12, 26, and 52 weeks. Overall, the results of the study revealed that the MOB group showed significantly betterresults in all outcomes across all time points, with the exception of sensory deficit at 52 weeks and reflex and motor deficits at 12 and 52 weeks. These improvements were clinically meaningful for neurodynamic testing and sensory deficits at 12 weeks, back pain intensity at 6 weeks, and for activity limitation, functional mobility, and quality of life outcomes at 6, 12, 26, and 52 weeks. The study suggests that mobilization combined with neurodynamic mobilization may offer more substantial long-term benefits than spinal manipulative therapy combined with the same.