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CTRI Number  CTRI/2025/07/091124 [Registered on: 18/07/2025] Trial Registered Prospectively
Last Modified On: 17/07/2025
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Physiotherapy (Not Including YOGA) 
Study Design  Randomized, Parallel Group, Active Controlled Trial 
Public Title of Study   Effectiveness of Nerve-Based Physical Therapy for Chronic Low Back Pain 
Scientific Title of Study   Effectiveness of Function Induced Neural Stretching and Distalo-Proximal Release Technique for the Management of Chronic Low Back Pain with Referred Symptoms 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Umma Maliha Nitu 
Designation  Undergraduate Student 
Affiliation  Jashore University of Science and Technology 
Address  Room no 304, Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology



7408
Other 
Phone  8801909464480  
Fax    
Email  mmalihachowdhury@gmail.com  
 
Details of Contact Person
Scientific Query  
Name  Dr Sharmila Jahan 
Designation  Assistant Professor 
Affiliation  Jashore University of Science and Technology 
Address  Room no 307, Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology



7408
Other 
Phone  8801717362485  
Fax    
Email  Sh.jahan@just.edu.bd   
 
Details of Contact Person
Public Query  
Name  Dr Sharmila Jahan 
Designation  Assistant Professor 
Affiliation  Jashore University of Science and Technology 
Address  Room no 307, Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology



7408
Other 
Phone  8801717362485  
Fax    
Email  sh.jahan@just.edu.bd   
 
Source of Monetary or Material Support  
Room no 301, Musculoskeletal Lab, Department of Physiotherapy and Rehabilitation, Dr MR Khan Medical Center, Jashore University of Science and Technology, Jashore-7408, Bangladesh 
 
Primary Sponsor  
Name  Dr Ehsanur Rahman 
Address  Room no 401, Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology, Jashore-7408, Bangladesh 
Type of Sponsor  Other [Self] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     Bangladesh  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Md Kabir Hossain  Musculoskeletal Lab, Dr MR Khan Medical Center, Department of Physiotherapy and Rehabilitation  Room no 301, Musculoskeletal Lab, Department of Physiotherapy and Rehabilitation, Dr MR Khan Medical Center, Jashore University of Science and Technology, Jashore-7408, Khulna division, Bangladesh

 		 8801778315139

kabir2002pt@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
IRB of Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: M958||Other specified acquired deformities of musculoskeletal system,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Conventional physiotherapy  Control Group: Conventional physiotherapy Warm-Up (5–7 minutes) Moist Heat Pack to Lumbosacral Area – 5 mins Pelvic Tilts & Bridges – 2 sets × 10 reps Main Treatment (20–25 minutes) Electrotherapy (10–15 mins) TENS (High-Frequency): 100 Hz, 100 µs, 15 mins OR Ultrasound Therapy (as appropriate): 1 MHz, 1.5 W/cm², 8 mins Exercise Therapy (10–15 mins) Core Stabilization Abdominal drawing-in – 2 sets × 10 reps Bridging – 2 sets × 10 reps Stretching Exercises Hamstring stretch – 30 sec × 3 Hip flexor stretch – 30 sec × 3 Functional Strength Sit-to-stand – 10 reps Step-ups – 10 reps Cool Down (5 minutes) Supine breathing + lumbar rolling (gentle) Forward bend to tolerance × 3 reps 
Intervention  Function Induced Neural Stretching and Distalo-Proximal Release Technique  Experimental Group: Function Induced Neural Stretching and Distalo-Proximal Release Technique Warm-Up (5–7 minutes) Dynamic Pelvic Tilts – 2 sets × 10 reps Cat-Cow Stretch – 2 sets × 10 reps Stationary cycling or treadmill walking (3 mins) Main Treatment (20–25 minutes) Function Induced Neural Stretching (10–12 mins) Sciatic Nerve Gliding: Supine SLR with DF/cervical flexion 3 sets × 10 reps; hold 3 seconds Femoral Nerve Stretch: Prone knee bend + cervical extension 3 sets × 10 reps; hold 3 seconds Slump Stretch with Functional Reaching 3 sets × 10 reps Distalo-Proximal Release Technique (10–12 mins) Manual release from foot to lumbar region: Plantar fascia & Achilles tendon release – 2 mins Calf & hamstrings deep tissue release – 3 mins Gluteal fascia & piriformis release – 3 mins Lumbar paraspinals MFR – 3 mins Cool Down (5 minutes) Supine Diaphragmatic Breathing – 2 mins Knee-to-chest stretch – 3 reps × 30 sec Lumbar rotation stretch – 10 reps 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  60.00 Year(s)
Gender  Both 
Details  Men and women aged 18 to 60 years.
Clinically and radiologically diagnosed Chronic Low Back Pain with Referred Symptoms.
Symptoms present for more than 4 weeks.
Positive straight leg raise.
Ability to give informed consent.
 
 
ExclusionCriteria 
Details  History of spinal surgery.
Systemic neurological conditions.
Pregnancy.
 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   Sequentially numbered, sealed, opaque envelopes 
Blinding/Masking   Participant and Outcome Assessor Blinded 
Primary Outcome  
Outcome  TimePoints 
Pain by Visual Analog Scale Score,
Pressure Pain Threshold
 		 6 weeks
 
 
Secondary Outcome  
Outcome  TimePoints 
Range of Motion (ROM) by using Digital Goniometer, Functional Disability by Oswestry Disability Index (ODI), Neural Mobility by Straight Leg Raise and Patient-Specific Functional Scale (PSFS)
 		 6 weeks 
 
Target Sample Size   Total Sample Size="80"
Sample Size from India="0" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   Date Missing 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  28/07/2025 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="0"
Months="6"
Days="0" 
Recruitment Status of Trial (Global)   Not Yet Recruiting 
Recruitment Status of Trial (India)  Not Applicable 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - YES
  1. What data in particular will be shared?
    Response - All of the individual participant data collected during the trial, after de-identification.

  2. What additional supporting information will be shared?
    Response -  Study Protocol

  3. Who will be able to view these files?
    Response - Anyone

  4. For what types of analyses will this data be available?
    Response - Any purpose.

  5. By what mechanism will data be made available?
    Response - Proposals should be directed to [Sh.jahan@just.edu.bd].

  6. For how long will this data be available start date provided 28-03-2026 and end date provided 09-04-2031?
    Response - Immediately following publication. No end date.

  7. Any URL or additional information regarding plan/policy for sharing IPD? 
    Additional Information - NIL
Brief Summary   This study aims to determine whether Function Induced Neural Stretching and Distalo Proximal Release Technique can produce superior outcomes in pain reduction and functional improvement compared to standard physiotherapy, thereby supporting a potentially more effective therapeutic approach for Chronic Low Back Pain with Referred Symptoms. The findings of this study will contribute to the evidence base for Neural Stretching and Distalo Proximal Release Technique in the conservative management of Chronic Low Back Pain with Referred Symptoms. 
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