Effectiveness of Neurodynamic Sliding Mobilisation in the "Slump" Position in Relation to the Perceptible Pain Threshold in Asymptomatic People

Effectiveness of Neurodynamic Sliding Mobilisation in the "Slump" Position in Relation to the Perceptible Pain Threshold in Asymptomatic People, a Cross-over Randomised Controlled Trial

According to the French National Health Agency, the use of manual therapy techniques is "possible" [grade B] as part of a multimodal combination of treatments for low back pain. These include so-called "neurodynamic" neural mobilisations, which aim in particular to desensitise the pain system and activate descending inhibitory pathways, with effects on pain and function in patients with nerve-related low back pain. Most of the available evidence does not explain the mechanisms involved in neural mobilisation in the slump position. Pain reduction is observed in more areas of the body with sliding techniques than with traction techniques.

In this cross-over, randomised controlled trial, we therefore hypothesise that the neurodynamic sliding technique in the slump position acts on mechanisms linked to central pain modulation processes

Inclusion Criteria:

Subjects aged 30 years or older and less than 65 years;

• Subjects considered naive to neurodynamic mobilisation techniques;
• Volunteers who have read and understood the information letter and have given their written consent to participate in the study;
• Fluent in spoken and read French;
• Effective contraception in women of childbearing age (progestin-only or intrauterine device or tubal ligation) for at least 12 months;
• For postmenopausal women, a confirmatory diagnosis must be obtained (non-drug-induced amenorrhoea for at least 12 months prior to the enrolment visit);
• Subject affiliated to a social security scheme.

Exclusion Criteria:

• Positive slump test on the day of the selection visit (production of asymmetric lumbar symptoms or painful radiations in at least one lower limb or unilateral reduction in physiological knee extension range of motion compared with the contralateral side);
• Neurological and neuropathic pain assessment score (DN4) greater than 4;
• Increase or decrease in sensory function in the lower limb compared with the contralateral side, as measured by Clinical Sensory Testing (CST);
• Any physical exertion of perceived intensity greater than 17 on the Borg 6-20 scale in the 72 hours prior to the trial and during the trial;
• Injury, complaint or symptom affecting the spine (cervical, thoracic, lumbar) and/or lower limb(s) requiring absence from work, school or leisure activities in the 12 months prior to enrolment;
• History of major surgery, injury to the trunk, spine and/or lower limb(s), or history of progressive rheumatic, neurological or oncological pathology;