Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT05753579 |
Other study ID # |
E-10879717-050.01.04 |
Secondary ID |
|
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
January 18, 2021 |
Est. completion date |
July 25, 2022 |
Study information
Verified date |
March 2023 |
Source |
Mus Alparlan University |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
Spinal mobilization methods are passive maneuvers that are made lighter and do not exceed the
physiological range of motion in order to increase joint mobility. Mobilization applications
are easier and safer than manipulation applications involving forceful pushing. Although
there are many literatures reporting the therapeutic efficacy of long-term mobilization
applications on LDH, there is no study on the effect of applications on radiological findings
of LDH.
In the light of the information mentioned above, the aim of this study is; To examine the
effect of mobilization applications on radiological findings and functional level in patients
with LDH
Description:
Disc herniation is the herniation of the nucleus pulposus, which is the disc material, into
the spinal canal along the fibers of the annulus fibrosus. Spinal herniations that affect the
whole spine are most common in the lumbar region, and most often in the L4-L5 and L5-S1
levels in this region. Lumbar disc herniation (LDH) is a common cause of low back pain,
radicular pain, and radiculopathy, resulting in disability. Depending on the size of the
herniation, the nerve is compressed in the lateral recess or in the foraminal or
extraforaminal space. The pathophysiology of pain includes direct nerve root compression and
local inflammation. Scientists have found that myelography is not as sensitive as magnetic
resonance imaging (MRI) in diagnosing lumbar disc herniation, and MRI has a higher positivity
rate. Compared with computed tomography, it has more imaging parameters, multiple tissue
variable functions, more flexible and comprehensive, no radiation and no harm to the human
body, and the diagnostic accuracy is better than CT scanning. Because of these advantages,
MRI is the gold standard imaging method in the diagnosis of LDH. There are various treatment
options available for LDH patients. These are basically divided into 2 categories: surgical
and conservative care. Conservative care includes oral medications, corticosteroid and
anesthetic infiltrations (nerve root injections), bed rest, exercise therapy,
flexion/distraction therapy, manipulation and mobilization.Mobilization applications are
passive movements that do not involve pushing or stimuli, applied within the range of motion
or up to the physiological range of motion. Mobilization has mechanical effects such as
increasing tissue flexibility, separating adhesions, relieving joint limitation and reducing
intra-articular pressure. Evidence suggests that mobilizations cause a neurophysiological
effect that results in sympathetic arousal, reduced neural mechanical sensitivity, mechanical
hypoalgesia, and normalized muscle activity, endurance, and pain-free strength.There are many
studies on the clinical use of mobilization methods. While most of these studies examine the
effects of mobilization on pain and functional status in patients with low back pain, there
are also studies examining the effects of mobilization on pain, functional status and
activities of daily living in patients with LDH. In the literature, it has been determined
that regression in the lumbar disc herniation distance is achieved with conservative
treatment and medical treatment approaches. It is observed that there are studies examining
the effect of manipulation on the herniation distance, which is one of the non-invasive
Spinal Decompression Therapy method and Manual therapy methods. However, there is no study in
the literature investigating the regression of spinal mobilization applications in LDH
patients.The aim of our study is to examine the effects of spinal mobilization applications
applied in three different planes in addition to stabilization exercises on radiological
findings such as herniation distance, disc height and facet joint distance in LDH patients.
Apart from radiological findings, it was also aimed to investigate the effects of patients on
functional status, pain and flexibility.