THE EFFECT OF SLING THERAPY ON THE DYNAMICS OF NEUROLOGICAL STATUS INDICATORS AND AUTONOMIC NERVOUS SYSTEM FUNCTION IN YOUNG ADULT MEN WITH RADICULAR MANIFESTATIONS OF LUMBAR SPINE OSTEOCHONDROSIS
DOI:
https://doi.org/10.67034/2786-8354.2026.20.2.09Keywords:
radicular syndrome, lumbar osteochondrosis, sling therapy, autonomic nervous system, autonomic tone, autonomic reactivity, cold pressor testAbstract
Introduction. To evaluate the effect of a structured course of sling therapy on the dynamics of neurological status indicators and autonomic nervous system (ANS) parameters in young adult men with radicular manifestations of lumbar spine osteochondrosis.
Materials and Methods. The study included 50 men aged 19–45 years with clinically verified L5, S1, or L5–S1 radiculopathies. A control group consisted of 25 healthy men, 15 of whom participated in the assessment of autonomic reactivity. Pain intensity (VAS), neurological symptoms, and ANS parameters were evaluated, including autonomic tone (Kerdo index), autonomic reactivity (cold pressor test), and autonomic support of activity (orthoclinostatic test). The intervention group completed a 12 session sling therapy program (45–60 minutes each), aimed at spinal decompression, activation of deep stabilizing muscles, and restoration of neuromuscular control. Assessments were performed before and after treatment. Statistical analysis was conducted using the Student’s t test for paired and independent samples when analyzing quantitative variables, and the χ² test or McNemar’s test when analyzing categorical changes. Statistical significance was set at p < 0,05.
Results. Before treatment, patients demonstrated severe pain (VAS 7.8 ± 1.3) and a high prevalence of reflex tonic and myotonic disturbances, including paravertebral tenderness, antalgic postures, restricted mobility, and positive tension signs. Following sling therapy, pain intensity significantly decreased to 3.1 ± 1.0 (p < 0.001). Marked improvement was observed in gait disturbances, muscle tonic syndrome, tenderness of myofascial trigger zones, and tension signs such as the Lasegue, Neri, and Dejerine tests (p < 0.001). Symptoms associated with proximal innervation (Wassermann, Matskevich) did not show significant change. Autonomic tone before treatment was dominated by sympathetic activity (58%), whereas after therapy its prevalence decreased to 34% (p = 0.01), accompanied by an increase in vagotonia to 56% (p = 0.03). Cold pressor test responses also improved: the systolic blood pressure rise decreased from 30.1 ± 1.4 to 22.4 ± 2.1 mmHg (p < 0.001), and the diastolic rise decreased from 18.2 ± 2.2 to 15.9 ± 2.0 mmHg (p < 0.001), indicating reduced hypersympathetic reactivity.
Conclusions. Sling therapy exerts a comprehensive beneficial effect on neurological status and autonomic regulation in patients with radicular manifestations of lumbar osteochondrosis. It significantly reduces pain, muscle tonic disturbances, and tension signs, while also normalizing autonomic tone and decreasing sympathetic reactivity. These findings support sling therapy as an effective rehabilitation approach targeting both somatic and autonomic mechanisms underlying radicular pain.
References
1. Krychun, I. I., Pashkovskyi, V. M., Zhukovskyi, O. O., Yaremchuk, O. B., & Filipets, O. O. (2025). Deiaki pokaznyky stanu vegetatyvnoi nervovoi systemy pry nevrolohichnykh proiavakh osteokhondrozu poperekovoho viddilu khrebta [Some indicators of the autonomic nervous system in neurological manifestations of lumbar spine osteochondrosis]. Naukovyi Visnyk Uzhhorodskoho Universytetu. Seriia “Medytsyna”, 1(71), 41–46. [in Ukrainian]. https://doi.org/10.32782/2415-8127.2025.71.7
2. Arslan, D., & Ünal Çevik, I. (2022). Interactions between the painful disorders and the autonomic nervous system. Agri, 34(3), 155–165. https://doi.org/10.14744/agri.2021.43078
3. Chou, R., Deyo, R., Friedly, J., Skelly, A., Hashimoto, R., Weimer, M., Fu, R., Dana, T., Kraegel, P., Griffin, J., & Grusing, S. (2017). Nonpharmacologic therapies for low back pain: A systematic review for an American College of Physicians clinical practice guideline. Annals of Internal Medicine, 166(7), 493–505.
4. Daradas, A., Kulthinee, S., Promsrisuk, T., Kesornwanichwattana, P., Thaingkrathok, P., Pongampai, S., Kongjaidee, P., Seeja, N., Poomvanicha, M., & Chotimol, P. (2024). Cardiovascular and ocular parameter alterations in response to cold pressor test in young adults. Diagnostics, 14(18), 2010. https://doi.org/10.3390/diagnostics14182010
5. Díaz-Sáez, M. C., La Touche, R., & Cuenca-Martínez, F. (2021). Comparative analysis of the autonomic nervous system response during movement representation in healthy individuals and patients with chronic low back pain: A prospective cohort study. Somatosensory & Motor Research, 38(1), 68–76. https://doi.org/10.1080/08990220.2020.1845137
6. Kim, M. H., Park, S. Y., & Kim, Y. L. (2019). Effects of sling exercise on trunk muscle activation and autonomic nervous system function in patients with lumbar instability. Journal of Back and Musculoskeletal Rehabilitation, 32(3), 1–8.
7. Kulthinee, S., Nernpermpisooth, N., Poomvanicha, M., Satiphop, J., Chuang-Ngu, T., Kaleeluan, N., Thawnashom, K., Manin, A., Kongchan, R., & Yinmaroeng, K. (2021). Cold pressor test influences the cardio-ankle vascular index in healthy overweight young adults. Pulse, 9, 30–37. https://doi.org/10.1159/000517617
8. Lamotte, G., Boes, C. J., Low, P. A., & Coon, E. A. (2021). The expanding role of the cold pressor test: A brief history. Clinical Autonomic Research, 31, 153–155. https://doi.org/10.1007/s10286-021-00796-4
9. Lee, J. H., Kim, S. Y., & Lee, S. M. (2020). Effects of sling exercise therapy on pain, disability, and autonomic balance in patients with chronic low back pain. Journal of Physical Therapy Science, 32(4), 245–251.
10. National Institute for Health and Care Excellence. (2020). Low back pain and sciatica in over 16s: Assessment and management (NICE Guideline NG59). https://www.nice.org.uk/guidance/ng59
11. Pontes-Silva, A., Bassi-Dibai, D., Fidelis-de-Paula-Gomes, C. A., Souza, C. D. S., Pires, F. O., Mostarda, C. T., & Dibai Filho, A. V. (2022). Comparison of the autonomic nervous system dysfunction between different chronic spine disorders: Neck pain versus low back pain. Revista da Associação Médica Brasileira, 68(9), 1288–1296. https://doi.org/10.1590/1806-9282.20220406
12. Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 166(7), 514–530.
13. Quispe, R. C., & Novak, P. (2021). Auxiliary tests of autonomic functions. Journal of Clinical Neurophysiology, 38(4), 262–273. https://doi.org/10.1097/WNP.0000000000000626
14. Sillevis, R., Cuenca-Zaldívar, J. N., Fernández-Carnero, S., García-Haba, B., Sánchez Romero, E. A., & Selva-Sarzo, F. (2023). Neuromodulation of the autonomic nervous system in chronic low back pain: A randomized, controlled, crossover clinical trial. Biomedicines, 11(6), 1551. https://doi.org/10.3390/biomedicines11061551
15. Szabo, S., Totka, Z., Nagy-Bozsoky, J., Pinter, I., Bagany, M., & Bodo, M. (2024). Rheoencephalography: A non-invasive method for neuromonitoring. Journal of Electrical Bioimpedance, 15(1), 10–25. https://doi.org/10.2478/joeb-2024-0003
16. Yeater, T. D., Cruz, C. J., Cruz-Almeida, Y., & Allen, K. D. (2022). Autonomic nervous system dysregulation and osteoarthritis pain: Mechanisms, measurement, and future outlook. Current Rheumatology Reports, 24(6), 175–183. https://doi.org/10.1007/s11926-022-01071-9
17. Zhang, J., Jiang, N., Xu, H., Wu, Y., Cheng, S., & Liang, B. (2024). Efficacy of cognitive functional therapy in patients with low back pain: A systematic review and meta-analysis. International Journal of Nursing Studies, 151, 104679. https://doi.org/10.1016/j.ijnurstu.2023.104679
18. Zhou, T., Salman, D., & McGregor, A. H. (2024). Recent clinical practice guidelines for the management of low back pain: A global comparison. BMC Musculoskeletal Disorders, 25(1), 344. https://doi.org/10.1186/s12891-024-07468-0
19. Ziemssen, T., & Siepmann, T. (2019). The investigation of the cardiovascular and sudomotor autonomic nervous system: A review. Frontiers in Neurology, 10, 53. https://doi.org/10.3389/fneur.2019.00053
