THE LONG-TERM EFFECTS OF A NEURODYNAMIC TREATMENT TECHNIQUE USING A

TREATMENT-BASED CLASSIFICATION APPROACH TO LOW BACK PAIN: A CASE REPORT

McCracking HV, Do DT
Manual Therapy Fellowship
School of Physical Therapy, Regis University, Denver, CO

Purpose: Procedures: Oswestry

The objective of this case study
is to illustrate the benefits of
introducing a neurodynamic
Discussion:
The patient was seen 7 times over 4 weeks. 50
Neurodynamic treatment
Treatment included manipulation for lumbar 40 techniques may be a key
hypomobility, targeted flexibility exercises 30
element in a manual therapy

treatment technique in a patient
whose progress had plateaued
using impairment-based manual
physical therapy interventions
for low back and lower
extremity pain.
Subject:
85 year-old female with
Percent
in the pelvic region, and lumbar stabilization care plan aimed at
20
exercises. A neurodynamic technique was improving function in
introduced at visit 5, supplemented with a 10 patients with low back and
similar self-treatment technique that was 0
lower extremity pain.
1 3 5 6 7 10 mo
included in the home program. Visit Number f/u
Results: Symptom Frequency Clinical Relevance:
Improvement of the patient’s symptoms 30
Patients with low back and
plateaued by visit 4 with an ODI score of 36%. 25
lower extremity pain who

Days Per Month

atraumatic onset of low back
and posterolateral thigh pain
approximately 1 year prior to
her initial visit. Frequency of
symptoms was reportedly 5 out
On visits 6 and 7 the ODI score was 27% and 20
present with positive
18%, respectively. At 10-month follow-up the 15
neurodynamic signs may
ODI score remained at 18% and frequency of
10
represent a subgroup of
5
symptoms was 2 days per month. individuals whose
0
functional ability and

u
t

it
si

F/
is
of 7 days and the baseline score

Vi

lV

th
frequency of symptoms

al

on
na
it i

-M
Fi
In
on the Modified Oswestry Low

10
improve with manual
Back Pain Disability physical therapy that
Questionnaire (ODI) was 42%. includes neurodynamic
Significant examination findings The patient’s lower extremity was placed in a straight leg raise position biased toward treatment techniques.
included positive neurodynamic adduction and internally rotation. The ankle was then passively dorsiflexed until the onset
of symptoms and held for 3-4 seconds. This was followed by a position of plantarflexion
signs. for the same duration. Ten repetitions of this maneuver were performed once each day for
approximately 10 days.