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J Manipulative Physiol Ther. 2015 Jul-Aug;38(6):365-74. doi: 10.1016/j.jmpt.2015.06.013. Epub 2015 Jul 26.

Short-term effects of Mulligan mobilization with movement on pain, disability, and kinematic spinal movements in patients with nonspecific low back pain: a randomized placebo-controlled trial.

Author information

1
Professor, Institute of Experimental and Clinical Research, Faculty of Motor Sciences, University of Louvain, Parnasse-ISEI, Brussels, Belgium; Head of Orthopedic Manual Therapy, Continuing Education Program, Institute of Experimental and Clinical Research, Faculty of Motor Sciences, University of Louvain, Brussels, Belgium. Electronic address: benjamin.hidalgo@uclouvain.be.
2
Head of Orthopedic Manual Therapy, Continuing Education Program, Institute of Experimental and Clinical Research, Faculty of Motor Sciences, University of Louvain, Brussels, Belgium; Professor, Institute of Experimental and Clinical Research, Faculty of Motor Sciences, University of Louvain, Brussels, Belgium.
3
Adjunct Senior Teaching Fellow, School of Physiotherapy, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
4
Professor, Institute of Experimental and Clinical Research, Faculty of Motor Sciences, University of Louvain, Brussels, Belgium.

Abstract

OBJECTIVE:

The purpose of this clinical study was to compare the immediate- and short-term effects of lumbar Mulligan sustained natural apophyseal glides (SNAGs) on patients with nonspecific low back pain with respect to 2 new kinematic algorithms (KA) for range of motion and speed as well as pain, functional disability, and kinesiophobia.

METHODS:

This was a 2-armed randomized placebo-controlled trial. Subjects, blinded to allocation, were randomized to either a real-SNAG group (n = 16) or a sham-SNAG group (n = 16). All patients were treated during a single session of real/sham SNAG (3 × 6 repetitions) to the lumbar spine from a sitting position in a flexion direction. Two new KA from a validated kinematic spine model were used and recorded with an optoelectronic device. Pain at rest and during flexion as well as functional disability and kinesiophobia was recorded by self-reported measures. These outcomes were blindly evaluated before, after treatment, and at 2-week follow-up in both groups.

RESULTS:

Of 6 variables, 4 demonstrated significant improvement with moderate-to-large effect sizes (ES) in favor of the real-SNAG group: KA-R (P = .014, between-groups ES Cliff δ = -.52), pain at rest and during flexion (visual analog scale, P < .001; ES = -.73/-.75), and functional-disability (Oswestry Disability Index, P = .003 and ES = -.61). Kinesiophobia was not considered to be significant (Tampa scale, P = .03) but presented moderate ES = -.46. Kinematic algorithms for speed was not significantly different between groups (P = .118) with a small ES = -.33. All 6 outcome measures were significantly different (P ≤ .008) during within-group analysis (before and after treatment) only in the real-SNAG group. No serious or moderate adverse events were reported.

CONCLUSION:

This study showed evidence that lumbar spine SNAGs had a short-term favorable effect on KA-R, pain, and function in patients with nonspecific low back pain.

KEYWORDS:

Low Back Pain; Musculoskeletal Manipulations; Randomized Controlled Trial

PMID:
26215900
DOI:
10.1016/j.jmpt.2015.06.013
[Indexed for MEDLINE]

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