Comparative Effects of Lower Body Quadrant Neural Mobilization and Stretching in Collegiate Football Players

Sports Physical Therapy Clinical Trial

Official title:

Comparative Effects of Lower Body Quadrant Neural Mobilization and Stretching in Collegiate Football Players

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT06298851
• Other study ID #: E-10840098-772.02-2026
• Status: Not yet recruiting
• Phase: N/A
• Start date: March 8, 2024
• Est. completion date: March 31, 2024

Study information

• Verified date: March 2024
• Source: Istanbul Medipol University Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Neural mobilizations (NM) are defined as interventions that aim to directly or indirectly affect neural structures or surrounding tissue through manual techniques or exercise. Neural mobilizations have been studied in both patients and healthy populations. In the study, individuals in the amateur football team will be divided into three groups and will be given pre-training warm-up periods, including neural mobilization, dynamic and static stretching.After the warm-up period, its effect on flexibility and performance will be examined and compared.

Description:

Neural mobilization (NM) is an intervention aimed at directly or indirectly affecting neural structures or surrounding tissue through manual techniques or exercise, used to restore the normal mechanical and physiological responses of the nervous system to movement and posture. Neural mobilization consists of two different techniques or combinations of these, which provides gliding and tension. Gliding techniques involve simultaneous movements of at least two joints, so that the nerve is lengthened in one joint and shortened in the other. In contrast, tension techniques lengthen the nerves in both joints. Neural gliding results in greater nerve excursion, while neural tension results in higher inner nerve pressure. It has been suggested that neural mobilization may induce a series of complex neurophysiological changes that facilitate its function by increasing nerve flexibility and improve symptoms such as improvement in nerve mobility, increase in intraneural fluid dispersion and pain by providing changes in the viscoelastic properties of the nerve. However, the underlying mechanisms associated with clinical improvements following neural mobilization remain unclear. The peripheral nervous system tolerates and adapts to different force combinations in daily activity and sports. The reason of these adaptations can be the gliding ability of the peripheral nervous system relative to adjacent connective tissue structures and the sliding of the internal fascicles towards each other. Decreased gliding ability of the peripheral nerve may affect function by causing increased stress on the nerve and local ischemic lesions. Neural mobilization is known to be effective in improving lower extremity function and flexibility. The flexibility of the lower extremities, especially the hamstring muscles, is important in increasing functionality and reducing the risk of injury in football players. Neurodynamics is used as an effective technique in increasing the flexibility of the hamstring muscles and reducing neural mechanosensitivity. Active involvement in warm-up periods can affect muscle strength and power, athletic performance, muscle adaptation and injury risk. The aim of this study is to examine the effects of static stretching, dynamic stretching and neural mobilization techniques used in the warm-up periods before training in collegiate football players on flexibility and performance and to compare the effects of these techniques with each other. Participants will be recruited from collegiate male soccer teams and they will be divided into three groups: neural mobilization, dynamic stretching and static stretching group.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 40
• Est. completion date: March 31, 2024
• Est. primary completion date: March 25, 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 25 Years

Eligibility

Inclusion Criteria:

• Between the ages of 18-25
• Not having had a lower or upper extremity injury in the last 3 months
• Not having had surgery in the last 6 months
• Playing amateur football regularly for at least 1 year

Exclusion Criteria:

• Orthopedic, neurological, rheumatological or cardiorespiratory health problems that would prevent them from performing the tests

Related Conditions & MeSH terms

• Sports Physical Therapy
• Stretch

Intervention

Other:
• Neural Mobilization Group (NMG)
Femoral nerve gliding: Mobilization of the femoral nerve will performed while the participant in the prone position and the hip hyperextended. Tension will applied by placing the knee in full flexion and the ankle in plantar flexion. Sciatic nerve gliding: Participants will take turns while sitting with the trunk in thoracic flexion; perform knee extension/dorsiflexion with cervical extension and knee flexion/plantar flexion with cervical flexion. Tension will applied by flexing the hip and dorsiflexing the ankle to the point where stress will felt. Peroneal nerve gliding: The participant will asked to maintain this position in a supine position by placing the ankle in inversion and plantar flexion. From a starting position consisting of ankle dorsiflexion, knee, and hip extension, the patient will return to the starting position by simultaneously performing ankle plantar flexion and inversion, full knee flexion, and 90 degrees of hip flexion.
• Dynamic Stretching Group (DSG)
Exercises will include functional activities that provided dynamic stretching of the hamstrings, quadriceps, hip flexor, extensor, abductor and adductor muscles, and gastrosoleus muscle. All stretching exercises will be performed in two circuits in an area of 15 m2. 4 sets of 10 repetitions will be performed, each exercise cycle lasting 6 seconds, and a 1-minute rest period will be given between sets. This process will be repeated for both extremities.
• Static Stretching Group (SSG)
Static stretching exercises will be described to the participants as given below: Standing quadriceps stretch: The participant will stand upright, fold one knee and bring the heel towards the buttock while holding the foot with one hand. Modified hamstring stretching: The participant will be in a seated position with one leg straight and will place the other foot on the inside of the straight leg and reach forward. Gastrocnemius stretching: The participant stands with feet 60-90 cm from the wall, leaning against the wall with both hands, keeping the back leg straight and the front leg slightly bent. Adductor stretching: Participants will be in a sitting position with an erect spine, bending and releasing their knees with the soles of their feet touching. Lumbar stretching: In a sitting position, participants keep one leg straight and place the other foot on the outside of the straight leg and rotate the body diagonally.

Locations

Country	Name	City	State
Turkey	Istanbul Medipol University	Istanbul

Sponsors (1)

Lead Sponsor	Collaborator
Istanbul Medipol University Hospital

Country where clinical trial is conducted

Turkey, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	One-Leg Forward Jump Test	A 2-meter tape measure will be placed on a flat surface for the test. Participants will be asked to stand on one leg with their toes remaining at zero on the tape measure, jump forward as much as possible with their hands on their waist, and land on the same foot. The place where he places his fingertip after jumping will be recorded by reading from the tape measure. Participants will be informed that they must maintain their position for 2 seconds after landing. The test will be applied separately for dominant and non-dominant feet. Participants will be given 1 trial application, followed by 3 tests and the best result will be recorded in centimeters. There will be a 30-second rest between tests.	From pre-interventional time to post-interventional about an hour
Other	T Test	The T test consists of 4 contact points formed in a T shape in an area of 10 meters long and 10 meters wide. In this test, the aim is to complete a series in the shortest time that requires the participant to move in different directions and in different ways between these contact points, and the participant always looks in the same direction. The participant will change direction by stepping forward, backward, right and left. This test requires covering a total distance of 40 meters, including 10 m forward, 10 m to the right, 10 m to the left and 10 m back.	From pre-interventional time to post-interventional about an hour
Other	BlazePod Reaction Time Determination Test	The BlazePod test, which includes "pods" equipped with touch sensors and LED lights, will be used to evaluate reaction time. The device can measure special abilities such as instantaneous speed and reflexes. For lower extremity measurement, three of the BlazePod pods will be attached to a wall 1.5 m above the floor, each 1.5 m apart. Athletes will start the test by standing in front of the middle section, 3 m away, with their feet shoulder-width apart and their knees slightly bent. During the test, when a single pod lights up at random, the athlete will run towards the light and touch the pod as quickly as possible. A total of 6 randomized light triggers will be used for a single trial and athletes will perform 2 trials with 3 minutes of rest. In the evaluation, the number of touches (counts) for 15 seconds, reaction time (ms) and average reaction time for the visual response of 15 seconds of touch will be analyzed.	From pre-interventional time to post-interventional about an hour
Primary	Straight Leg Raise Test	The passive straight leg raise test will be used to determine changes in the flexibility of the hamstring muscle. With the participant in the supine position, the lateral condyle of the femur, fibular head, and fibular malleolus will be identified. The axis of a goniometer will be placed over the protrusion of the greater trochanter of the femur. One of the arms of the goniometer will be placed parallel to the table. The knee and ankle will be kept in the extension position. By holding the talus and without rotating the hip, flexion of the hip will be gradually increased. Participants' lower extremities will be elevated until they complain of pain in the rear thigh area. Care will be taken to ensure that they do not bend their knees and that the pelvis is not in retroversion. Then, the other arm of the goniometer will be placed in the direction of the line between the head of the fibula and the fibular malleolus and the degree of height of the straight leg will be noted.	From pre-interventional time to post-interventional about an hour
Secondary	Y Balance Test	Participants will stand on the foot plate in the center of the Y Balance Test area. Participants will be instructed to maintain a single-leg stance while reaching as far as possible with the opposite leg and return to the starting position on the middle platform without losing balance. In the test, participants will be allowed 3 attempts for both lower extremities and will be asked to reach the maximum distance in 3 directions anterior, posteromedial and posterolateral. The maximum reach distance will be recorded for each consecutive attempt.	From pre-interventional time to post-interventional about an hour