Authors :
Simran Kanojia; Dr. Tayyaba Munawar
Volume/Issue :
Volume 10 - 2025, Issue 9 - September
Google Scholar :
https://tinyurl.com/4mks2k4y
Scribd :
https://tinyurl.com/3cftxepw
DOI :
https://doi.org/10.38124/ijisrt/25sep118
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Abstract :
Introduction:
Lumbar radiculopathy is one of the consequence of Lumbar Disc Herniation which leads to functional impairment,
sensory abnormalities, and radiating discomfort. Conventional physiotherapy includes exercise therapy use of electrical
modalities Neural mobilization technique offers symptomatic relief. However, techniques like AOT (Action Observation
Therapy) works on cortical neuroplasticity and possible results in pain modulation. NTM (Neural Tissue Mobilizaton) works
on lengthening of of nerve leading to pain relief and improving functional recovery.
Methodology:
The experimental study included thirty-four people between 20 and 50 years with unilateral lumbar radiculopathy
brought on by grade 1–2 disc protrusion. Participants underwent AOT (action observation followed by imitation of lumbar
stabilization and stretch exercises) and NTM (slider technique in supine and slump sitting) over four weeks. Baseline
assessment and four weeks measurements of pain intensity were done using the Numerical Pain Rating Scale (NPRS) and
disability using the Modified Roland-Morris Disability Questionnaire (RMDQ).
Results:
Post-intervention, pain was substantially decreased (mean NPRS: 5.03 to 2.26; p < 0.01, 55.4% reduction) and disability
was reduced (mean RMDQ: 14.59 to 5.21; p < 0.01; 65.2% reduction). These improvements show that the combined protocol
successfully controlled pain and improved functional condition.
Conclusion:
AOT in conjunction NTM is an effective therapy for pain modulation and disability reduction in lumbar radiculopathy.
The method builds on neuroplasticity via visual-motor engagement while addressing mechanical nerve mobility, therefore
implying a synergistic benefit over conventional therapy.
Abbreviations:
AOT: Action Observation Therapy, NTM: Neural Tissue Mobilization NPRS: Numerical Pain Rating Scale, RMDQ:
Roland Morris Disability Questionnaire, ROM: Range of motion, TENS: Transcutaneous Electrical Neuromuscular
Stimulation, IFT: Interferential Therapy, MNS: Mirror Neuron System, ICC: Intraclass Correlation Coefficient, SLR:
Straight Leg Raise, MRI: Magnetic Resonance Imaging, SIP: Sickness Impact Profile.
Keywords :
Lumbar Radiculopathy, Action Observation Therapy, Neural Tissue Mobilization, Neuroplasticity, Conventional Therapy.
References :
- Das S, Dowle P, Iyengar R. Effect of spinal mobilization with leg movement as an adjunct to neural mobilization and conventional therapy in patients with lumbar radiculopathy: Randomized controlled trial. J Med Sci Res [Internet]. 2018;6(1):11–9.
- Madavi SK, Chakole V, Sen J, Singam A, Rallabhandi S, Verma N. Comparison of Lumbar Transforaminal Epidural Dexamethasone and Triamcinolone for Lumbar Radiculopathy. J Evol Med Dent Sci [Internet]. 2020;9(42):3133–8.
- Berry JA, Elia C, Saini HS, Miulli DE. A review of lumbar radiculopathy, diagnosis, and treatment. Cureus [Internet]. 2019;11(10): e5934.
- Chaurasia BD. BD chaurasia’s human anatomy, volume 2: Regional and applied dissection and clinical:Lower limb, abdomen and pelvis. Vol. 2. New Delhi, India: CBS Publishers & Distributors; 2019.
- Clark R, Weber RP, Kahwati L. Surgical management of lumbar radiculopathy: a systematic Reviews. Journal of general internal medicine. 2020; 35:855–64.
- Singh V, Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, India, Malik M, Kaur J, Punia S, Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, India, et al. Disentangling the lumbar PIVD puzzle: A narrative review. Rom J Neurol [Internet]. 2020;19(4):228–36.
- Vanti C, Panizzolo A, Turone L, Guccione AA, Violante FS, Pillastrini P, et al. Effectiveness of mechanical traction for lumbar radiculopathy: A systematic review and meta-analysis. Phys Ther [Internet]. 2021;101(3).
- Lorio M, Kim C, Araghi A, Inzana J, Yue JJ. International Society for the Advancement of Spine Surgery Policy 2019-surgical treatment of lumbar disc herniation with radiculopathy. International journal of spine surgery. 2020; 14:1–7.
- Lin L-H, Lin T-Y, Chang K-V, Wu W-T, Özçakar L. Neural mobilization for reducing pain and disability in patients with lumbar radiculopathy: A systematic review and meta-analysis. Life (Basel) [Internet]. 2023;13(12):2255.
- Ryan D, Fullen B, Rio E, Segurado R, Stokes D, O’Sullivan C. Effect of action observation therapy in the rehabilitation of neurologic and musculoskeletal conditions: A systematic review. Arch Rehabil Res Clin Transl [Internet]. 2021;3(1):100106.
- Alghadir A, Anwer S, Iqbal A, Iqbal Z. Test–retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. J Pain Res [Internet]. 2018; 11:851–6.
- Roland M, Fairbank J. The Roland-Morris disability questionnaire and the Oswestry disability questionnaire. Spine (Phila Pa 1976) [Internet]. 2000;25(24):3115–24.
- Asghari A. Psychometric properties of a modified version of the Roland- Morris Disability Questionnaire (M-RMDQ).
- Paolucci T, Pezzi L, Coraci D, Tognolo L, Pantalone A, Attanasi C, et al. Reliability, concurrent validity, and clinical performances of the shorter version of the Roland Morris Disability Questionnaire in a sample of Italian people with non-specific low back pain. J Pers Med [Internet]. 2024;14(7):740.
- Liyew WA. Clinical presentations of lumbar disc degeneration and lumbosacral nerve lesions. Int J Rheumatol [Internet]. 2020; 2020:2919625.
- Morales Tejera D, Fernandez-Carnero J, Suso-Martí L, Cano-de-la-Cuerda R, Lerín-Calvo A, Remón-Ramiro L, et al. Comparative study of observed actions, motor imagery and control therapeutic exercise on the conditioned pain modulation in the cervical spine: a randomized controlled trial. Somatosens Mot Res [Internet]. 2020;37(3):138–48.
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- Bello B, Danazumi MS, Kaka B. Comparative effectiveness of 2 manual therapy techniques in the management of lumbar radiculopathy: A randomized clinical trial. J Chiropr Med [Internet]. 2019;18(4):253–60.
Introduction:
Lumbar radiculopathy is one of the consequence of Lumbar Disc Herniation which leads to functional impairment,
sensory abnormalities, and radiating discomfort. Conventional physiotherapy includes exercise therapy use of electrical
modalities Neural mobilization technique offers symptomatic relief. However, techniques like AOT (Action Observation
Therapy) works on cortical neuroplasticity and possible results in pain modulation. NTM (Neural Tissue Mobilizaton) works
on lengthening of of nerve leading to pain relief and improving functional recovery.
Methodology:
The experimental study included thirty-four people between 20 and 50 years with unilateral lumbar radiculopathy
brought on by grade 1–2 disc protrusion. Participants underwent AOT (action observation followed by imitation of lumbar
stabilization and stretch exercises) and NTM (slider technique in supine and slump sitting) over four weeks. Baseline
assessment and four weeks measurements of pain intensity were done using the Numerical Pain Rating Scale (NPRS) and
disability using the Modified Roland-Morris Disability Questionnaire (RMDQ).
Results:
Post-intervention, pain was substantially decreased (mean NPRS: 5.03 to 2.26; p < 0.01, 55.4% reduction) and disability
was reduced (mean RMDQ: 14.59 to 5.21; p < 0.01; 65.2% reduction). These improvements show that the combined protocol
successfully controlled pain and improved functional condition.
Conclusion:
AOT in conjunction NTM is an effective therapy for pain modulation and disability reduction in lumbar radiculopathy.
The method builds on neuroplasticity via visual-motor engagement while addressing mechanical nerve mobility, therefore
implying a synergistic benefit over conventional therapy.
Abbreviations:
AOT: Action Observation Therapy, NTM: Neural Tissue Mobilization NPRS: Numerical Pain Rating Scale, RMDQ:
Roland Morris Disability Questionnaire, ROM: Range of motion, TENS: Transcutaneous Electrical Neuromuscular
Stimulation, IFT: Interferential Therapy, MNS: Mirror Neuron System, ICC: Intraclass Correlation Coefficient, SLR:
Straight Leg Raise, MRI: Magnetic Resonance Imaging, SIP: Sickness Impact Profile.
Keywords :
Lumbar Radiculopathy, Action Observation Therapy, Neural Tissue Mobilization, Neuroplasticity, Conventional Therapy.