Effectiveness of Action Observation Therapy with Neural Tissue Mobilization for Pain Modulation and Disability in Lumbar Radiculopathy: An Experimental Study

Introduction: Lumbar radiculopathy is one of the consequence of Lumbar Disc Herniation which leads to functional impairment, sensory abnormalities, and radiating discomfort. Conventional physiotherapy includes exercise therapy use of electrical modalities Neural mobilization technique offers symptomatic relief. However, techniques like AOT (Action Observation Therapy) works on cortical neuroplasticity and possible results in pain modulation. NTM (Neural Tissue Mobilizaton) works on lengthening of of nerve leading to pain relief and improving functional recovery.  Methodology: The experimental study included thirty-four people between 20 and 50 years with unilateral lumbar radiculopathy brought on by grade 1–2 disc protrusion. Participants underwent AOT (action observation followed by imitation of lumbar stabilization and stretch exercises) and NTM (slider technique in supine and slump sitting) over four weeks. Baseline assessment and four weeks measurements of pain intensity were done using the Numerical Pain Rating Scale (NPRS) and disability using the Modified Roland-Morris Disability Questionnaire (RMDQ).  Results: Post-intervention, pain was substantially decreased (mean NPRS: 5.03 to 2.26; p < 0.01, 55.4% reduction) and disability was reduced (mean RMDQ: 14.59 to 5.21; p < 0.01; 65.2% reduction). These improvements show that the combined protocol successfully controlled pain and improved functional condition.  Conclusion: AOT in conjunction NTM is an effective therapy for pain modulation and disability reduction in lumbar radiculopathy. The method builds on neuroplasticity via visual-motor engagement while addressing mechanical nerve mobility, therefore implying a synergistic benefit over conventional therapy.  Abbreviations: AOT: Action Observation Therapy, NTM: Neural Tissue Mobilization NPRS: Numerical Pain Rating Scale, RMDQ: Roland Morris Disability Questionnaire, ROM: Range of motion, TENS: Transcutaneous Electrical Neuromuscular Stimulation, IFT: Interferential Therapy, MNS: Mirror Neuron System, ICC: Intraclass Correlation Coefficient, SLR: Straight Leg Raise, MRI: Magnetic Resonance Imaging, SIP: Sickness Impact Profile.