Impact of passive versus active sciatic nerve mobilization on rehabilitation outcomes in chronic lumbar radiculopathy

Abstract

Background: Radiculopathy, caused by nerve root compression, is a common source of pain and disability. Literature shows mixed evidence regarding nerve mobilization to improve chronic lumbar radiculopathy. This study was conducted to assess the impact of passive vs active sciatic nerve mobilization on rehabilitation outcomes among patients with lumbar radiculopathy.

Methods: This was a randomized controlled trial (parallel design) conducted at the Helping Hand Institute of Rehabilitation Sciences, Mansehra (Khyber Pakhtunkhwa). Based on study selection criteria, a total of 40 patients (Males n=13 and Females n= 27) with active complaint of chronic radicular low back pain were recruited in the study. The mean age of participants was 40.48 ± 6.73 years. All the patients were randomly assigned into two groups (Group Active and Group Passive). Each group received 20 patients. Patients in both groups received segmental lumbar mobilization and leg-pull traction in addition to active sciatic nerve mobilization based on Butler’s technique (Group Active only) and passive sciatic nerve mobilization based on Butler’s technique (Group Passive only). Baseline and post treatment assessment was performed using following outcome measures: pain (Numeric Pain Rating Scale), range of motion (goniometer) and patient reported objective measure (Oswestry Disability Index).

Results: The Wilcoxon signed-rank test revealed statistically significant improvements in rehabilitation outcomes included pain, range of motion, and functional disability index within both mobilization groups (p<0.001). Between-group analysis using the Mann–Whitney U test demonstrated that group with passive mobilization nerve was statistically better in gaining greater improvements in pain, straight leg raise range and disability (p <0.05).

Conclusion: Both active and passive neural mobilization techniques, when combined with Maitland segmental mobilization and leg-pull traction technique, were effective in decreasing pain and improving functional status and lumbar range of motion in patients with chronic lumbar radiculopathy. However, passive neural mobilization demonstrated statistically greater improvement.