A total of 60 participants were randomly allocated to the following interventions which were carried out for 6 sessions over a 2-week period:
- Neural mobilization exercises (4 point kneeling pelvic tilts and heel sitting) and transcutaneous electrical stimulation (TENS) (50 minutes)
- An identical program, with the addition of SMWLM (55 minutes)
As per the principles of the Mulligan technique, all participants in this study needed to demonstrate improvement in their Straight Leg Raise (SLR) range with one application of the SMWLM technique to be included in this study.
The SMWLM technique involved the participant lying on their unaffected side and moving their affected leg to their pain-free range of SLR. In the meantime, the therapist applied a transverse pressure on the spinous process above the affected spinal level. This was repeated for 2-3 sets of 6-8 repetitions with pain-free overpressure applied to the SLR range as a progression of the technique. This was followed by a passive hip/ knee flexion/ extension neural slider technique in the same position.
Both groups demonstrated improvements in symptoms, however the addition of SMWLM had significantly greater short and long-term outcomes in patient satisfaction, pain, disability and SLR ROM.