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Title: Straight Leg Raise treatment for individuals with spinally referred leg pain : exploring characteristics that influence outcome
Author: Ridehalgh, Colette
ISNI:       0000 0004 5348 4870
Awarding Body: University of Brighton
Current Institution: University of Brighton
Date of Award: 2014
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The primary aim of this thesis was to assess the differences in response to a 3 x 1 minute SLR tensioner treatment between 3 sub-groups of individuals with spinally referred leg pain (somatic referred pain, radicular pain and radlculopathy). · Preliminary studies of the 3 outcome measures were required prior to the main study. These were: validity ofthe method to measure nerve excursion using ultrasound imaging (VI) which was assessed in pig nerves; repeatability of sciatic nerve excursion during a side-lying modified SLR measured with UI in the posterior thigh, and repeatability of pressure pain thresholds (PPT) and vibration thresholds (VT). The 3 outcome measures were repeatable and the sciatic nerve excursion technique was valid. Sixty seven participants were placed into one of the 3 sub-groups and further assessed to identify the presence of central sensitisation (CS). Five questionnaires were completed by participants to assess disability and psychological characteristics. Sciatic nerve excursion, PPT and VT were measured prior to and after a 3 x 1 minute SLR tensioner technique. No significant differences (p>O.05) were found for any of the 3 outcome measures between the 3 groups. Slight improvements in VT were seen in the radiculopathy group after treatment, which were not significant, but indicated that even in individuals with conduction loss, no detrimental changes to nerve conduction occurred after treatment. A varied response to nerve excursion was seen. Longitudinal nerve excursion at the posterior thigh decreased after treatment in individuals with pain below the knee; this location of pain being more common in the radiculopathy and radicular groups. The decrease in nerve excursion suggests regional changes to nerve compliance after treatment, which may have occurred at the nerve root. Since it was n.ot possible to measure nerve root excursion, these findings are speculative. Only 2 participants were identified with CS, suggesting a low prevalence of the condition in individuals with spinaUy referred leg pain. This may be-Clue to individuals with CS choosing not to participate in the study, or a limitation of the method used to identify CS. Disability and psychological factors were not significantly different at baseline between the 3 sub-groups, and were not correlated with the outcome measures. A 3 x 1 minute SLR tensioner technique in individuals with spinally referred leg pain of greater than 3 months of duration is not effective in improving pain or nerve conduction. However, it is not harmful, even in individuals with loss of nerve conduction. Changes to nerve excursion after treatment may be related to individual differences in nerve compliance, and possibly restriction of the nerve root.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: B000 Health Professions