Impact of Lower Limb Neural Mobilization on Neuromuscular Function and Calf Muscle Thickness in Elderly Individuals With Sarcopenia

Summary

Sarcopenia is a common age-related condition characterized by a gradual loss of muscle mass, strength, and physical performance. This can make everyday activities such as walking, standing, and maintaining balance more difficult for older adults, increasing the risk of falls and reducing independence. The lower limb muscles, especially the calf muscles, play an essential role in movement and stability. When these muscles weaken, it can significantly affect balance and mobility. While traditional management of sarcopenia focuses on strengthening exercises and nutrition, there is increasing interest in approaches that also target the nervous system to improve overall function.

This study aims to examine the effect of lower limb neural mobilization on selected neuromuscular variables, namely static balance, fall risk, and ankle muscle strength as well as calf muscle thickness in elderly individuals with sarcopenia. Neural mobilization is a physiotherapy technique designed to improve the movement and flexibility of nerves. In the lower limbs, nerves such as the sciatic, tibial, and common peroneal nerves are responsible for transmitting signals between the brain and muscles. With aging or reduced activity, these nerves may become less mobile, which can affect muscle activation and coordination. Neural mobilization involves gentle, controlled movements that help restore normal nerve mobility, improve blood flow, and enhance communication between the nerves and muscles.

In this study, static balance refers to the ability to maintain a stable standing position without losing balance. Fall risk indicates the likelihood of experiencing a fall, which is a major concern in older adults. Ankle muscle strength is crucial because the ankle plays a key role in maintaining posture and responding to balance disturbances. Calf muscle thickness is an indicator of muscle mass and is commonly measured using imaging techniques such as ultrasound. Together, these measures provide a comprehensive understanding of an individual's physical function and safety.

Participants in this study will typically be individuals aged 60 years and above with sarcopenia. They will first undergo assessments to evaluate their balance, fall risk, ankle strength, and calf muscle thickness. Following this, they will participate in a structured program involving lower limb neural mobilization, which may be combined with OTAGO exercises. The intervention will be conducted by trained professionals over a set period. After completing the program, participants will be reassessed to determine any improvements.

Neural mobilization is a safe and non-invasive technique, and participants may only feel a gentle stretching sensation during the procedure. The potential benefits include improved balance, increased ankle strength, reduced risk of falls, and enhanced muscle size. These improvements can lead to better mobility, greater independence, and improved quality of life. For families and healthcare providers, this study highlights the importance of combining muscle and nerve-focused treatments in managing sarcopenia. Overall, this research aims to support more effective rehabilitation strategies for healthy aging and fall prevention in the elderly population.

Conditions

• Sarcopneia in Elderly Individuals

Interventions

OTHER

Neural Mobilization

Neural Mobilization + Otago Exercises Intervention Description: Participants will receive lower limb neural mobilization along with the Otago Exercise Program (OEP). Neural mobilization involves gentle, guided movements of the hip, knee, and ankle to improve nerve mobility. Common peroneal and tibial nerve were mainly focused on this intervention. Each nerve mobilized for 5 set with 10 repetitions with 60 seconds of rest period between the set. Along with the Neural Mobilization this group also undergo Otago Exercise which consist of Balance, Strengthening and Stretching exercises for the Lower limb for a period of 30 minutes.

OTHER

Otago Exercise

Participants in the control group will receive Otago Exercise for a period of 30 minutes. This exercise components are specifically focused to enhance Balance, Strength of the lower extremity.

Sponsors & Collaborators

• INTI International University

  lead OTHER

Principal Investigators

• Premavati Lekshmanan · INTI International University

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-11-04

Primary Completion

2026-04-05

Completion

2026-05-24

Countries

• Malaysia

Study Locations