EFFECT OF BENT LEG RAISE TECHNIQUE ON PAIN AND FUNCTIONAL DISABILITY AMONG PATIENTS WITH SPECIFIC LOW BACK PAIN WITH RADICULOPATHY – A RANDOMIZED CONTROLLED TRIAL.

Abstract

Background: Low back pain (LBP), especially with radiculopathy, is a leading cause of disability worldwide. Specific LBP, often due to prolapsed intervertebral disc (PIVD), can severely impact quality of life and functional ability. The prevalence of LBP among young Indian adults (18–35 years) is reported to range between 42% and 83%, with a significant proportion experiencing radiculopathy — pain, numbness, or weakness radiating into one or both lower limbs due to nerve root involvement. The L4, L5, and S1 nerve roots are most frequently involved, with clinical signs such as positive straight leg raise (SLR) test and difficulty performing trunk flexion or sitting. Despite numerous available treatment guidelines, consensus is still lacking on the most effective management for LBP with radiculopathy, particularly regarding non-surgical interventions. Physiotherapy is a main stay in conservative management, employing techniques aimed at reducing pain, restoring function, and improving neural mobility. Among these, the Mulligan Bent Leg Raise (BLR) technique is a manual therapy procedure that aims to enhance neural and soft tissue mobility without provoking pain. The technique is proposed to restore normal limb movement, alleviate neural tension, and ultimately decrease pain and disability, but high-quality evidence supporting its superiority over conventional regimens remains limited. Aim: To study the effect of bent leg raise technique on pain & functional disability in patients with specific low back pain with radiculopathy. Methods: Subjects were screened according to inclusion and exclusion criteria. Ethical clearance was obtained from the institutional ethical committee. The purpose & procedure of the study was explained to participant. Subjects were screened according to the inclusion and exclusion criteria .A written consent were obtained. Total 36 subjects were included in the study. Selected participants for specific low back pain with radiculopathy were assessed by straight leg raise test (SLR). Selected participants pain intensity measured by using Numerical pain rating scale[ ICC = 0.96 ] and functional disability was measured by using Oswestry Disability Index (ODI) [ICC = 0.90] . Study subjects who had reduced pain intensity & functional disability also had positive straight leg raise test was divided into 2 groups i.e. Group A and Group B. Group A subjects were received Mulligan Bent leg raise technique for 3 repetition of 7–10 seconds per session, five sessions in one week and McKenzie extension exercises (10 repetition with 10 second hold ; 5 days per week for 1 week ). Group B were received Conventional physiotherapy, combining neural tissue mobilization [2 min (with 1 minute rest in-between sets) Repetition: 3 sets ] and McKenzie extension exercises (10 repetition with 10 second hold ; 5 days per week for 1 week ). Baseline and post-intervention assessments included the Numerical Pain Rating Scale and Oswestry Disability Index. Data were analyzed using paired and unpaired t-tests to compare within and between groups, with p < 0.05 considered significant. Results: Within-group analysis: Both interventions significantly reduced pain and disability scores from pre- to post-treatment (p < 0.0001). Between-group comparison: Both the techniques shows equal effect on reducing pain and functional disability among patients with specific low back pain with radiculopathy. Conclusion: Both the Mulligan BLR technique along with Mckenzie extension exercises and Conventional physiotherapy provided significant short-term relief in pain and improvement in functional disability in young adults with specific LBP and radiculopathy. Keywords: Lumbar radiculopathy, Specific Low back pain, Mulligan bent leg raise , Mckenzie extension exercises, Neural tissue mobilization, Numerical Pain Rating Scale, Oswestry Disability Index.