Sciatic Nerve
Conditions
Brief summary
The purposes of the study are: 1. To measure differences in Sciatic nerve (SN) stiffness using shear-wave elastography (SWE) during two movement sequences of the lower limb neurodynamic test (LLNT) in low back pain with sciatica. 2. To measure differences in Sciatic nerve stiffness using shear-wave elastography during two movement sequences of the lower limb neurodynamic test in control group. 3. To compare difference in Sciatic nerve stiffness using shear-wave elastography during two movement sequences of the lower limb neurodynamic test between low back pain patients with sciatica and control group.
Detailed description
As peripheral nerves can exhibit regional variations in their anatomy and mechanical properties, investigating the response of different nerve segments to different loading patterns based on the order of joint movement will provide a better understanding of nerve biomechanics during neurodynamic testing. This may help optimize the lower limb neurodynamic test (LLNT) application for different pathological situations and potentially increase its diagnostic capacity to detect localized alterations in a specific nerve segment such as sciatica. Ultrasonography does not have the sensitivity required to detect all forms of peripheral nerve disorders and fails to provide information about nerve mechanical properties such as stiffness. By using neurodynamic sequencing, clinicians may direct neural stress toward targeted areas suspected of involvement and, at the same time, perform the test with reduced load on more remote nerve segments. The ability to modify neural load distribution during the LLNT could play an interesting role in differential diagnosis, when symptoms present similar characteristics but have different regional origin. There is a gap in the literature concerning the measurement of (SWV) of sciatic nerve during LLNT proximal (LLNT-PROX) to distal and from distal (LLNT\_DIST) to proximal sequences of LLNT.
Interventions
DIAGNOSTIC_TESTLower Limb Neurodynamic Test (LLNT) with Shear Wave Elastography
Participants underwent sciatic nerve stiffness assessment using shear wave elastography during two distinct sequences of the lower limb neurodynamic test. Each participant received: Proximal-to-distal sequence: Starting with hip flexion, followed by knee extension, then ankle dorsiflexion with toe extension. Distal-to-proximal sequence: Starting with ankle dorsiflexion and toe extension, followed by knee extension, then hip flexion.
Sponsors
Cairo University
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
25 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* Thirty participants ranging in age from 25 to 40 years from both genders with a diagnosis of low back pain with radiating leg pain and thirty control group. * The main symptoms are low back pain with unilateral leg pain(sciatica) for 3-12 months for group A. * Patients with lumbar disc herniation (L4-5) with diagnostic imaging as MRI for group A. * Positive straight leg raising are considered for inclusion in the study for group A. * Control group must be free from any symptoms of nerve irritation or compression, with normal neurological examination findings, including reflexes, sensation, negative straight leg raising and motor strength.
Exclusion criteria
* Diabetes mellitus. * Any type of polyneuropathy * Trauma of lumbar spine * Previous history of back surgery * Piriformis syndrome. * Participants with conditions that reduce image quality on US imaging (thick gluteal subcutaneous fat tissue. * Hip joint prosthesis. * Professional athletes (Neto et al., 2024). * Skin infection
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Shear Wave Velocity (SWV) measured in meters per second (m/s) | 20 minutes, During a single assessment session at baseline | Quantitative measurement of sciatic nerve stiffness during two different movement sequences of the Lower Limb Neurodynamic Test (LLNT). Higher SWV values indicate increased nerve stiffness. |
Countries
Egypt
Contacts
Primary ContactManar Fawzy Mohammed Hussein, M.Sc
Backup ContactEbtisam Abdelkareem Ali, PhD
Outcome results
None listed