{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T23:24:48Z","timestamp":1784071488607,"version":"3.55.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,30]]},"DOI":"10.7759\/cureus.63501","type":"journal-article","created":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T11:05:06Z","timestamp":1719745506000},"source":"Crossref","is-referenced-by-count":4,"title":["Effects of Multimodal Physical Therapy on Pain, Disability, H-reflex, and Diffusion Tensor Imaging Parameters in Patients With Lumbosacral Radiculopathy Due to Lumbar Disc Herniation: A Preliminary Trial"],"prefix":"10.7759","author":[{"given":"Mohamed","family":"Badr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hosny","family":"Elkhawaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Fawaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Kasem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Fayez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1410151","article-title":"Sciatica","volume":"372","author":"Ropper AH","year":"2015","unstructured":"Ropper AH, Zafonte RD. Sciatica. N Engl J Med. 2015, 372:1240-8. 10.1056\/NEJMra1410151","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2007.01.008","article-title":"Lumbosacral radiculopathy","volume":"25","author":"Tarulli AW","year":"2007","unstructured":"Tarulli AW, Raynor EM. Lumbosacral radiculopathy. Neurol Clin. 2007, 25:387-405. 10.1016\/j.ncl.2007.01.008","journal-title":"Neurol Clin"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0b013e3182146e55","article-title":"Characterization of the incidence and risk factors for the development of lumbar radiculopathy","volume":"25","author":"Schoenfeld AJ","year":"2012","unstructured":"Schoenfeld AJ, Laughlin M, Bader JO, Bono CM. Characterization of the incidence and risk factors for the development of lumbar radiculopathy. J Spinal Disord Tech. 2012, 25:163-7. 10.1097\/BSD.0b013e3182146e55","journal-title":"J Spinal Disord Tech"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2013.08.003","article-title":"An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy","volume":"14","author":"Kreiner DS","year":"2014","unstructured":"Kreiner DS, Hwang SW, Easa JE, et al.. An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine J. 2014, 14:180-91. 10.1016\/j.spinee.2013.08.003","journal-title":"Spine J"},{"key":"ref5","article-title":"Segmental H-reflex studies in upper and lower limbs of patients with radiculopathy","volume":"71","author":"Sabbahi MA","year":"1990","unstructured":"Sabbahi MA, Khalil M. Segmental H-reflex studies in upper and lower limbs of patients with radiculopathy. Arch Phys Med Rehabil. 1990, 71:223-7.","journal-title":"Arch Phys Med Rehabil"},{"key":"ref6","article-title":"A study on new diagnostic criteria of H reflex","volume":"37","author":"Han TR","year":"1997","unstructured":"Han TR, Kim JH, Paik NJ. A study on new diagnostic criteria of H reflex. Electromyogr Clin Neurophysiol. 1997, 37:241-50.","journal-title":"Electromyogr Clin Neurophysiol"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-4-102","article-title":"H-reflex amplitude asymmetry is an earlier sign of nerve root involvement than latency in patients with S1 radiculopathy","volume":"4","author":"Alrowayeh HN","year":"2011","unstructured":"Alrowayeh HN, Sabbahi MA. H-reflex amplitude asymmetry is an earlier sign of nerve root involvement than latency in patients with S1 radiculopathy. BMC Res Notes. 2011, 4:102. 10.1186\/1756-0500-4-102","journal-title":"BMC Res Notes"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-007-0516-z","article-title":"Principles and implementation of diffusion-weighted and diffusion tensor imaging","volume":"37","author":"Roberts TP","year":"2007","unstructured":"Roberts TP, Schwartz ES. Principles and implementation of diffusion-weighted and diffusion tensor imaging. Pediatr Radiol. 2007, 37:739-48. 10.1007\/s00247-007-0516-z","journal-title":"Pediatr Radiol"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0279499","article-title":"Nerve abnormalities in lumbar disc herniation: a systematic review and meta-analysis of diffusion tensor imaging","volume":"17","author":"Wang N","year":"2022","unstructured":"Wang N, Sun D, Zhang X, Xi Z, Li J, Xie L. Nerve abnormalities in lumbar disc herniation: a systematic review and meta-analysis of diffusion tensor imaging. PLoS One. 2022, 17:10.1371\/journal.pone.0279499","journal-title":"PLoS One"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-018-4247-6","article-title":"Current concepts for lumbar disc herniation","volume":"43","author":"Benzakour T","year":"2019","unstructured":"Benzakour T, Igoumenou V, Mavrogenis AF, Benzakour A. Current concepts for lumbar disc herniation. Int Orthop. 2019, 43:841-51. 10.1007\/s00264-018-4247-6","journal-title":"Int Orthop"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2023.02.022","article-title":"A systematic review of clinical practice guidelines for persons with non-specific low back pain with and without radiculopathy: identification of best evidence for rehabilitation to develop the WHO's package of interventions for rehabilitation","volume":"104","author":"Zaina F","year":"2023","unstructured":"Zaina F, C\u00f4t\u00e9 P, Cancelliere C, et al.. A systematic review of clinical practice guidelines for persons with non-specific low back pain with and without radiculopathy: identification of best evidence for rehabilitation to develop the WHO's package of interventions for rehabilitation. Arch Phys Med Rehabil. 2023, 104:1913-27. 10.1016\/j.apmr.2023.02.022","journal-title":"Arch Phys Med Rehabil"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-022-07356-y","article-title":"How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis","volume":"32","author":"Dove L","year":"2023","unstructured":"Dove L, Jones G, Kelsey LA, Cairns MC, Schmid AB. How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis. Eur Spine J. 2023, 32:517-33. 10.1007\/s00586-022-07356-y","journal-title":"Eur Spine J"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18116176","article-title":"Manual therapy in cervical and lumbar radiculopathy: a systematic review of the literature","volume":"18","author":"Kuligowski T","year":"2021","unstructured":"Kuligowski T, Skrzek A, Cie\u015blik B. Manual therapy in cervical and lumbar radiculopathy: a systematic review of the literature. Int J Environ Res Public Health. 2021, 18:10.3390\/ijerph18116176","journal-title":"Int J Environ Res Public Health"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2021-104926","article-title":"Does motor control training improve pain and function in adults with symptomatic lumbar disc herniation? A systematic review and meta-analysis of 861 subjects in 16 trials","author":"Pourahmadi M","year":"2022","unstructured":"Pourahmadi M, Delavari S, Hayden JA, et al.. Does motor control training improve pain and function in adults with symptomatic lumbar disc herniation? A systematic review and meta-analysis of 861 subjects in 16 trials. Br J Sports Med. 2022, 10.1136\/bjsports-2021-104926","journal-title":"Br J Sports Med"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2023.100549","article-title":"Effectiveness of interferential current in patients with chronic non-specific low back pain: a systematic review with meta-analysis","volume":"27","author":"Rampazo \u00c9P","year":"2023","unstructured":"Rampazo \u00c9P, J\u00fanior MA, Corr\u00eaa JB, de Oliveira NT, Santos ID, Liebano RE, Costa LO. Effectiveness of interferential current in patients with chronic non-specific low back pain: a systematic review with meta-analysis. Braz J Phys Ther. 2023, 27:10.1016\/j.bjpt.2023.100549","journal-title":"Braz J Phys Ther"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.697986","article-title":"Myofascial release for chronic low back pain: a systematic review and meta-analysis","volume":"8","author":"Wu Z","year":"2021","unstructured":"Wu Z, Wang Y, Ye X, et al.. Myofascial release for chronic low back pain: a systematic review and meta-analysis. Front Med (Lausanne). 2021, 8:10.3389\/fmed.2021.697986","journal-title":"Front Med (Lausanne)"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1179\/106698101790819707","article-title":"The short-term effect of lumbar positional distraction","volume":"9","author":"Mitchell UH","year":"2013","unstructured":"Mitchell UH, Wooden MJ, McKeough DM. The short-term effect of lumbar positional distraction. J Man Manip Ther. 2013, 9:213-21. 10.1179\/106698101790819707","journal-title":"J Man Manip Ther"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1179\/jmt.1993.1.3.83","article-title":"Positional distraction, a radiological confirmation","volume":"1","author":"Creighton DS","year":"2013","unstructured":"Creighton DS. Positional distraction, a radiological confirmation. J Man Manip Ther. 2013, 1:83-6. 10.1179\/jmt.1993.1.3.83","journal-title":"J Man Manip Ther"},{"key":"ref19","article-title":"Maitland\u2019s Vertebral Manipulation: Management of Neuromusculoskeletal Disorders - Volume 1","year":"2013","unstructured":"Maitland\u2019s Vertebral Manipulation. Management of Neuromusculoskeletal Disorders - Volume 1. Hengeveld E, Banks K (ed): Elsevier Health Sciences, 2013."},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2017.07.003","article-title":"Changes in lower limb strength and function following lumbar spinal mobilization","volume":"40","author":"Yuen TS","year":"2017","unstructured":"Yuen TS, Lam PY, Lau MY, Siu WL, Yu KM, Lo CN, Ng J. Changes in lower limb strength and function following lumbar spinal mobilization. J Manipulative Physiol Ther. 2017, 40:587-96. 10.1016\/j.jmpt.2017.07.003","journal-title":"J Manipulative Physiol Ther"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1080\/10669817.2023.2192975","article-title":"Effects of spinal manipulation or mobilization as an adjunct to neurodynamic mobilization for lumbar disc herniation with radiculopathy: a randomized clinical trial","volume":"31","author":"Danazumi MS","year":"2023","unstructured":"Danazumi MS, Nuhu JM, Ibrahim SU, et al.. Effects of spinal manipulation or mobilization as an adjunct to neurodynamic mobilization for lumbar disc herniation with radiculopathy: a randomized clinical trial. J Man Manip Ther. 2023, 31:408-20. 10.1080\/10669817.2023.2192975","journal-title":"J Man Manip Ther"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2010.08.013","article-title":"Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study","volume":"33","author":"McMorland G","year":"2010","unstructured":"McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ. Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. J Manipulative Physiol Ther. 2010, 33:576-84. 10.1016\/j.jmpt.2010.08.013","journal-title":"J Manipulative Physiol Ther"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/78.7.754","article-title":"Low back exercises: evidence for improving exercise regimens","volume":"78","author":"McGill SM","year":"1998","unstructured":"McGill SM. Low back exercises: evidence for improving exercise regimens. Phys Ther. 1998, 78:754-65. 10.1093\/ptj\/78.7.754","journal-title":"Phys Ther"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2009.2796","article-title":"Gluteal muscle activation during common therapeutic exercises","volume":"39","author":"Distefano LJ","year":"2009","unstructured":"Distefano LJ, Blackburn JT, Marshall SW, Padua DA. Gluteal muscle activation during common therapeutic exercises. J Orthop Sports Phys Ther. 2009, 39:532-40. 10.2519\/jospt.2009.2796","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1123\/jsr.2012-0082","article-title":"Muscle activation levels of the gluteus maximus and medius during standing hip-joint strengthening exercises using elastic-tubing resistance","volume":"23","author":"Youdas JW","year":"2014","unstructured":"Youdas JW, Adams KE, Bertucci JE, Brooks KJ, Nelson MM, Hollman JH. Muscle activation levels of the gluteus maximus and medius during standing hip-joint strengthening exercises using elastic-tubing resistance. J Sport Rehabil. 2014, 23:1-11. 10.1123\/jsr.2012-0082","journal-title":"J Sport Rehabil"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2005.03.003","article-title":"Clinically important outcomes in low back pain","volume":"19","author":"Ostelo RW","year":"2005","unstructured":"Ostelo RW, de Vet HC. Clinically important outcomes in low back pain. Best Pract Res Clin Rheumatol. 2005, 19:593-607. 10.1016\/j.berh.2005.03.003","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000632","article-title":"Cross-cultural translation, adaptation, and psychometric testing of the Roland-Morris disability questionnaire into modern standard Arabic","volume":"39","author":"Maki D","year":"2014","unstructured":"Maki D, Rajab E, Watson PJ, Critchley DJ. Cross-cultural translation, adaptation, and psychometric testing of the Roland-Morris disability questionnaire into modern standard Arabic. Spine (Phila Pa 1976). 2014, 39:1537-44. 10.1097\/BRS.0000000000000632","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.2217\/pmt-2018-0034","article-title":"Does the use of interferential current prior to pilates exercises accelerate improvement of chronic nonspecific low back pain?","volume":"8","author":"Franco YR","year":"2018","unstructured":"Franco YR, Franco KF, Silva LA, Silva MO, Rodrigues MN, Liebano RE, Cabral CM. Does the use of interferential current prior to pilates exercises accelerate improvement of chronic nonspecific low back pain?. Pain Manag. 2018, 8:465-74. 10.2217\/pmt-2018-0034","journal-title":"Pain Manag"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2013.04.003","article-title":"Magnetic resonance imaging zygapophyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side-posture positioning: a randomized controlled mechanisms trial with blinding","volume":"36","author":"Cramer GD","year":"2013","unstructured":"Cramer GD, Cambron J, Cantu JA, et al.. Magnetic resonance imaging zygapophyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side-posture positioning: a randomized controlled mechanisms trial with blinding. J Manipulative Physiol Ther. 2013, 36:203-17. 10.1016\/j.jmpt.2013.04.003","journal-title":"J Manipulative Physiol Ther"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2018.7476","article-title":"Unraveling the mechanisms of manual therapy: modeling an approach","volume":"48","author":"Bialosky JE","year":"2018","unstructured":"Bialosky JE, Beneciuk JM, Bishop MD, Coronado RA, Penza CW, Simon CB, George SZ. Unraveling the mechanisms of manual therapy: modeling an approach. J Orthop Sports Phys Ther. 2018, 48:8-18. 10.2519\/jospt.2018.7476","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2019.8827","article-title":"Changes in structure and function of the back muscles in low back pain: different time points, observations, and mechanisms","volume":"49","author":"Hodges PW","year":"2019","unstructured":"Hodges PW, Danneels L. Changes in structure and function of the back muscles in low back pain: different time points, observations, and mechanisms. J Orthop Sports Phys Ther. 2019, 49:464-76. 10.2519\/jospt.2019.8827","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1038\/srep44678","article-title":"Microstructural changes are coincident with the improvement of clinical symptoms in surgically treated compressed nerve roots","volume":"7","author":"Wu W","year":"2017","unstructured":"Wu W, Liang J, Chen Y, Chen A, Wu Y, Yang Z. Microstructural changes are coincident with the improvement of clinical symptoms in surgically treated compressed nerve roots. Sci Rep. 2017, 7:44678. 10.1038\/srep44678","journal-title":"Sci Rep"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000005106","article-title":"Microstructural changes in compressed nerve roots treated by percutaneous transforaminal endoscopic discectomy in patients with lumbar disc herniation","volume":"95","author":"Wu W","year":"2016","unstructured":"Wu W, Liang J, Chen Y, Chen A, Wu B, Yang Z. Microstructural changes in compressed nerve roots treated by percutaneous transforaminal endoscopic discectomy in patients with lumbar disc herniation. Medicine (Baltimore). 2016, 95:10.1097\/MD.0000000000005106","journal-title":"Medicine (Baltimore)"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003925","article-title":"Quantitative evaluation of intraspinal lumbar disc herniation-related lumbosacral radiculopathy before and after percutaneous transforaminal endoscopic discectomy using diffusion tensor imaging","volume":"46","author":"Shi Y","year":"2021","unstructured":"Shi Y, Zhao F, Dou W, et al.. Quantitative evaluation of intraspinal lumbar disc herniation-related lumbosacral radiculopathy before and after percutaneous transforaminal endoscopic discectomy using diffusion tensor imaging. Spine (Phila Pa 1976). 2021, 46:734-42. 10.1097\/BRS.0000000000003925","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.98B3.36036","article-title":"Diffusion tensor imaging of radiculopathy in patients with lumbar disc herniation: preliminary results","volume":"98","author":"Eguchi Y","year":"2016","unstructured":"Eguchi Y, Oikawa Y, Suzuki M, et al.. Diffusion tensor imaging of radiculopathy in patients with lumbar disc herniation: preliminary results. Bone Joint J. 2016, 98:387-94. 10.1302\/0301-620X.98B3.36036","journal-title":"Bone Joint J"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/257086-effects-of-multimodal-physical-therapy-on-pain-disability-h-reflex-and-diffusion-tensor-imaging-parameters-in-patients-with-lumbosacral-radiculopathy-due-to-lumbar-disc-herniation-a-preliminary-trial","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T11:05:11Z","timestamp":1719745511000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/257086-effects-of-multimodal-physical-therapy-on-pain-disability-h-reflex-and-diffusion-tensor-imaging-parameters-in-patients-with-lumbosacral-radiculopathy-due-to-lumbar-disc-herniation-a-preliminary-trial"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,30]]},"references-count":35,"URL":"https:\/\/doi.org\/10.7759\/cureus.63501","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2024,6,30]]}}}