Efficacy of Combining Mulligan Spinal Mobilization With Leg Movement and Mechanical Lumbar Traction in Lumbar Radiculopathy

Summary

Lumbar radiculopathy (LR), often caused by disc herniation, results in significant pain, disability, and reduced quality of life. Spinal Mobilization with Leg Movement (SMWLM) is a manual technique that has shown promise, while mechanical lumbar traction is used to reduce nerve compression, though its standalone effectiveness is debated. This randomized controlled trial aims to compare the combined effect of SMWLM plus mechanical lumbar traction against SMWLM alone, both administered with conventional physiotherapy. Outcomes will be assessed over 4 weeks to determine if the combined intervention offers superior pain relief, functional improvement, and range of motion in patients with unilateral L4-L5 or L5-S1 radiculopathy.

Conditions

• Lumbar Radiculopathy

Interventions

PROCEDURE

Spinal Mobilization with Leg Movement (SMWLM)

The therapist positions the patient side-lying on the unaffected side with the affected leg slightly abducted. A sustained transverse manual glide is applied to the spinous process of the superior vertebra of the involved lumbar segment (e.g., L4 for an L4-L5 lesion). Simultaneously, the patient actively lifts the leg into hip flexion and knee extension, ensuring the movement remains pain-free. Dosage: 3 sets of 7-10 repetitions per treatment session.

PROCEDURE

Mechanical Lumbar Traction

Following SMWLM, the patient is placed supine in a Fowler position with hips and knees flexed to 90°, lower legs supported. An intermittent distractive force (up to 50% of body weight) is delivered using an automatic traction device (e.g., PH-T3021). The traction cycle consists of a 30-second hold and a 10-second rest, with a 1-minute ramp-up and ramp-down, for a total of 15 minutes.

PROCEDURE

Conventional Physical Therapy

All participants receive a standardized conventional therapy program consisting of: * Moist hot pack on the lumbar region for 10 minutes. * Transcutaneous electrical nerve stimulation (TENS) with 50-100 ms pulse width for 10 minutes, electrodes placed over the lumbar spine and affected lower limb. * Supervised therapeutic exercises: heel sitting (lumbar flexion), drawing-in maneuver, bridging, and pelvic tilting (2 sets of 5-7 repetitions per session). * Home exercise program: same exercises performed daily, 3 sets of 10 repetitions, with progression as tolerated.

Sponsors & Collaborators

• KMU-Institute of Health Sciences, Islamabad

  collaborator UNKNOWN

• Khyber Medical University Peshawar

  lead OTHER

Principal Investigators

• Muhammad Haris, DPT · Institute of Health Science, Khyber Medical University Islamabad

• Dr Muhammad Mustafa, MSPT · Institute of Health Science, Khyber Medical University Islamabad

• Kinza Afzal, DPT · Hamdard University Islamabad Campus

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

20 Years

Max Age

50 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-04-01

Primary Completion

2026-10-15

Completion

2026-11-15

Countries

• Pakistan

Study Locations