Effects of Neurodynamics Versus Neurodynamic Sustained Natural Apophyseal Glide in Lumbosacral Radiculopathy

Abstract

Lumbosacral radiculopathy is a frequently reported health issue in middle-aged people, with a prevalence varying fromabout 2.2% to 8%. Neurodynamic mobilization (NM) and Neurodynamic sustained natural apophyseal glide (N-SNAG) techniqueswere proven effective for Lumbosacral radiculopathy. But controversies are prevalent regarding the effectiveness of their treatmentin previous studies. N-SNAG is also a comparatively new technique that is clinically being used around, but more literature is neededto analyze its effectiveness. Hence, we aimed to evaluate the efficacy of N-SNAG in comparison with NM and conventional generalexercises in treating lumbosacral radiculopathy on pain, mobility, disability, muscle activation, and health-related quality of life(HRQL). One hundred and twenty-seven patients aged between 30 and 50 years were randomly allocated into 3 different treatmentgroups, where the first and second groups received N-SNAG and NM with general exercises, and the third (control) group receivedgeneral exercises only. Range of motion of lumbar and hip flexion, active straight leg raising, low back pain, radiculopathy pain, muscleactivation of biceps femoris and gastrocnemius muscles, disability, and HRQL were evaluated at baseline, and the end of 1st week, 2ndweek, 7th week and 18th week for all the groups. Two-way repeated measure ANOVA with Bonferroni’s t-test revealed significant(p<0.05) improvement in the range of lumbar and hip flexion, LBP, radiculopathy pain, active SLR, disability, and HRQL in both withingroups and between groups. Muscle activation of biceps femoris and gastrocnemius also improved significantly (p<0.05) in all threegroups, but no significant (p>0.05) differences were seen between groups. The study concludes that N-SNAG is more efficient thanNM and general exercise in improving pain, lumbar and hip flexion range, SLR, disability, Muscle activation, and HRQL in Lumbosacralradiculopathy patients.