The Effect of a Neurodynamic Treatment on Nerve Conduction in Clients with Low Back Pain

Abstract

<p>Neurodynamics refers to the mechanical and physiological components of</p> <p>the nervous system and the interconnections between them (Shacklock, 1995).</p> <p>This is a phase 1 pilot trial investigating the immediate effect of a neurodynamic</p> <p>treatment as compared to a sham treatment in eight participants with low back</p> <p>pain. Primary outcome measures included: H-reflex latency and nerve</p> <p>conduction velocity. Secondary outcome measures included: the sitting slump</p> <p>test and visual analog scale for pain following a neurodynamic treatment</p> <p>compared to a sham treatment on eight participants with low back pain. T-tests</p> <p>were used to analyze any differences between the groups at baseline and post-</p> <p>intervention. No statistically significant differences were observed between the</p> <p>groups at baseline. Statistically significant differences were noted post-</p> <p>intervention between the treatment groups for H-reflex latency (t(5)=4.323,</p> <p>p=0.008) and the unaffected leg sitting slump test (t(5)=3.402, p=0.019). The H-</p> <p>reflex latency increased for the group following the neurodynamic treatment and</p> <p>decreased following the sham treatment. This was not expected and is of</p> <p>interest due to the possible mechanisms that may be underlying these</p> <p>phenomena. Despite the small sample size used in this study, differences were</p> <p>observed and displayed trends that were unanticipated. These between-group</p> <p>differences are of interest but require further investigation using a larger sample</p> <p>population. Sample size calculations for future studies based on the primary</p> <p>outcome measures yielded a sample of 2008 participants. This accounted for</p> <p>both a 20% difference between the two groups and a 20% dropout rate. Future</p> <p>studies need to investigate the most beneficial length of time, type and dosage of</p> <p>neurodynamic treatments, as well as, the most appropriate times to assess the</p> <p>outcome measures. Comparison to controls would be beneficial in subsequent</p> <p>studies.</p>