Effect of Thoracic Mobilization on Lumbar Radiculopathy

Study Overview
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Brief Summary
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The purpose of the study will be to: To investigate the effect of thoracic mobilization on back and leg pain in patients with lumbosacral radiculopathy. To investigate the effect of thoracic mobilization on functional disability in patients with lumbosacral radiculopathy. To investigate the effect of thoracic mobilization on proprioception in patients with lumbosacral radiculopathy.

Detailed Description
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To investigate the effect of thoracic mobilization on back and leg pain, functional disability and proprioception in patients with lumbosacral radiculopathy. 1-Thirty four patients of both sexes with unilateral chronic lumbar radiculopathy at L4-L5 or/ and L5-S1 levels will participate in this study. The patients will be diagnosed as having lumbar radiculopathy based on careful clinical examination by neurologist . The diagnosis will be confirmed by CT scan or MRI. Patients will be recruited from the outpatient clinic of Faculty of Physical Therapy, Cairo University and private clinics. Patients in this study will be randomly divided into two groups. Group (I) which will include 17 patients who will receive manual mobilization exercises in addition to selected physical therapy . Group (II) which will include 17 patients who will receive selected physical therapy. The treatment will conducted 3 sessions per week for 6 weeks.

Official Title
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Effect of Thoracic Spine Mobilization on Pain, Functional Disability and Proprioception in Patients With Lumbosacral Radiculopathy.

Conditions
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Lumbosacral Radiculopathy

Intervention / Treatment
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* Other: thoracic mobilization


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with unilateral chronic lumbosacral radiculopathy at L4- L5 or / and L5-S1 levels confirmed by MRI. The age of patients will be ranged from 30 to 45 years. Duration of pain will be more than 12 weeks. Patients with a positive straight leg raising (SLR) test. Patients with sufficient cognitive abilities that enables them to understand and follow instructions . Patients had to report an average pain level of more than five on the Visual Analogue Scale (VAS) and a lumbar spine range of motion (ROM) of at least 50% of the accepted normal range. Patients with body mass index< 30kg/m2 Exclusion Criteria: Cauda equina syndrome. Ankylosing spondylitis, thoracic deformities (pectus carinatum, excavatum), spina bifida, fractures, postoperative spinal conditions, diabetes, inflammatory processes. Previous inner ear infection or vestibular disorder with unresolved balance disturbance, history of head trauma with residual neurological deficits. Spinal tumor. Previous lumbar surgery. Sever musculoskeletal disease. Peripheral mononeuropathies or polyneuropathy. Obesity . Pregnancy.

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: thoracic mobilization group<br>which will include 17 patients who will receive thoracic manual mobilization exercises in addition to selected physical therapy .The treatment will conducted for 45 minutes, 3 sessions per week for 6 weeks. | Other: thoracic mobilization<br>* Thoracic mobilization will be performed for the thoracic spine mobilization group, thoracic mobilization therapy will be performed for five minutes.<br>|
| No Intervention: control group<br>which will include 17 patients who will receive selected physical therapy.The treatment will conducted for 45 minutes, 3 sessions per week for 6 weeks. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| functional disability | we will use Oswestry Disability Index (ODI) | baseline | 
| pain level | we will use Visual analogue scale (VAS) | baseline | 
| lumbar proprioception | we will use The Biodex System 3 pro isokinetic dynamometer | baseline |