Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Physical Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

First Advisor

Emilio "Louie" Puentedura

Date of original Performance / Presentation

January 2022

Publication Date / Copyright Date

1-1-2022

Abstract

Background: Neurodynamic mobilization (NM) is used in physical therapy (PT) for conditions including low back pain (LBP) and nerve-related LBP (N-LBP). Studies demonstrate improvements in pain, disability and function using various protocols, but no consensus regarding optimal parameters for NM. Purpose: The purpose of this dissertation was to seek consensus from experts in neurodynamics regarding NM dosage parameters, then test the parameters for safety, improving straight-leg-raise (SLR), forward bending (FB), self-reported pain, and disability. Research Design and Methods: Two studies were conducted. The first was a modified Delphi study seeking consensus regarding NM dosage parameters in a hypothetical patient. The second study was a prospective, longitudinal, multi-center, quasi-experimental, cohort study of DPT students to test the Delphi study parameters. Analysis: For the Delphi study, a 70% agreement level was utilized to determine consensus. For the second study, descriptive statistics and the Friedman test with Bonferroni correction were calculated to compare measurements at three time points. Results: Eighteen experts participated in the Delphi study. After 2 rounds, consensus was reached on 42 of 43 questions and a protocol was developed. For the second study, six PTs participated and 87 students met the inclusion/exclusion criteria. SLR and FB improved significantly after NM in the majority of subjects without LBP, regardless of home exercise program (HEP) performance. Measurements after 3-days were also improved to a significant degree. The greatest improvement in SLR and FB were in those who adhered very well to the HEP. No changes were reported in pain or disability in those reporting LBP or N-LBP, both demonstrating a floor effect. No adverse effects were reported. Conclusion: The Delphi study was successful at developing consensus for NM parameters for a patient with N-LBP. The protocol was determined to be safe. Subjects with reports of LBP generally did not improve in SLR or FB, however those without LBP improved in both post NM and after 3-days. Close adherence to a HEP was important for optimal improvement in both SLR and FB. No changes were found in either disability or pain levels in subjects reporting LBP, however levels of both were quite low.

Disciplines

Physical Therapy

Keywords

Low back pain; Nerve-related low back pain; Neurodynamics; Physical Therapy; Straight Leg Raise

Download
To access this thesis/dissertation you must have a valid nova.edu OR mynsu.nova.edu email address and create an account for NSUWorks.

Free My Thesis

If you are the author of this work and would like to grant permission to make it openly accessible to all, please click the Free My Thesis button.

  Contact Author

Share

 
COinS