Background: Lumbar radiculopathy caused by disc herniation is frequently accompanied by pain, functional disability, and impairments in sensorimotor control, including reduced proprioception and altered motor control. Interventions that integrate neural and mechanical components may enhance rehabilitation outcomes beyond exercise alone.
Objectives: To investigate the effects of manual therapy combined with neurodynamic exercise and motor control exercise (MTN) with motor control exercise alone (MCE) on lumbar proprioception, motor control, and functional disability in patients with lumbar radiculopathy.
Design: Randomized, single-blind clinical trial.
Methods: Thirty patients with lumbar radiculopathy due to L4–S1 disc herniation were randomly assigned to either the MTN group or the MCE group. Both groups participated in supervised interventions three times per week for six weeks. The MTN group received lumbar joint mobilization and slider-based neurodynamic mobilization integrated with motor control exercise, whereas the MCE group performed motor control exercise only. Lumbar proprioception was assessed using joint position error during trunk flexion and extension. Motor control was evaluated using pressure biofeedback–based abdominal drawing- in performance. Functional disability was assessed using the Korean version of the Oswestry Disability Index. Outcomes were measured at baseline and during follow-up.
Results: Significant group-by-time effects were observed for lumbar joint position error, motor control outcomes, and functional disability. The MTN group demonstrated earlier and greater improvements across all outcome measures compared with the MCE group, whereas improvements in the MCE group were more gradual.
Conclusion: Compared with motor control exercise alone, the addition of manual therapy and neurodynamic exercise resulted in superior improvements in lumbar proprioception, motor control, and functional disability. An integrated MTN approach may be an effective rehabilitation strategy for patients with lumbar radiculopathy.