Neural management plus advice to stay active on clinical measures and sciatic neurodynamic for patients with chronic sciatica: protocol for a controlled randomised clinical trial

Leticia Amaral Corrêa, Juliana Valentim Bittencourt, Maria Alice Mainenti Pagnez, Stephanie Mathieson, Bruno Tirotti Saragiotto, Gustavo Felicio Telles, Ney Armando Meziat Filho, Leandro Alberto Calazans Nogueira

Research output: Contribution to conferencePosterpeer-review

Abstract

Research Aim/Objective: To compare the effects of adding neural management to advice to stay active versus advice to stay active alone in improving pain intensity and functional limitation. Secondarily, to compare the effects of the experimental intervention in the sciatic neurodynamic, pain modulation, and psychosocial factors.

Research Methods: A parallel-group, controlled, examiner-blinded superiority clinical trial randomised at a 1:1 will be conducted in 210 participants with chronic sciatica, recruited from outpatient physiotherapy clinics and advertisements. Intervention group will receive neural management for 10 weekly sessions, plus advice to stay active on their daily living activities for 5 biweekly sessions lasting 30 minutes/session each. Control group will receive only advice to stay active. Primary outcome will be reduction in pain intensity and functional limitation. Secondary outcomes will include neuropathic symptoms, sciatic neurodynamic, pain modulation, and psychosocial factors. Data will be collected at 5, 10, and 26 weeks. Adverse events and patient satisfaction will be assessed. Ethical approval and trial registration has been granted (RBR-3db643c). Intention-to treat analysis will determine betweengroup difference using mixed linear models.

Results: It is expected that participants in both groups will show clinical improvement in their condition. However, we expect participants in the intervention group to have greater reduction in pain intensity, improved function, and improved neurodynamic of the sciatic nerve after the treatment period in a superior manner when compared to the control group. We anticipate none to minimum adverse events to occur, and participants will be positively satisfied with the treatment in both groups.

Discussion: Patients with sciatica are unrepresented in clinical practice guidelines for low back pain. This project has considerable relevance due to the high social impact generated by the offer of free care and subsequent monitoring of these who suffers from chronic sciatica from the metropolitan area of Rio de Janeiro, Brazil. It has also the potential to contribute to the literature by the evidence of the used treatment protocol in clinical practice and in future research.
Original languageEnglish
Pages128
Number of pages1
Publication statusPublished - 2021
EventThe 17th International Forum for Back and Neck Pain Research in Primary care: 2021 Back and Neck Pain Forum - Virtual
Duration: 11 Nov 202113 Nov 2021

Conference

ConferenceThe 17th International Forum for Back and Neck Pain Research in Primary care
Period11/11/2113/11/21

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