Use the Back button in your browser to see the other results of your search or to select another record.

Detailed Search Results

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 [with consumer summary]
Hidalgo B, Pitance L, Hall T, Detrembleur C, Nielens H
Journal of Manipulative and Physiological Therapeutics 2015 Jul-Aug;38(6):365-374
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 (3x6 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 = 0.014, between-groups ES Cliff delta = -0.52), pain at rest and during flexion (visual analog scale p < 0.001; ES -0.73/-0.75), and functional-disability (Oswestry Disability Index p = 0.003 and ES = -0.61). Kinesiophobia was not considered to be significant (Tampa scale p = 0.03) but presented moderate ES -0.46. Kinematic algorithms for speed was not significantly different between groups (p = 0.118) with a small ES -0.33. All 6 outcome measures were significantly different (p <= 0.008) 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.
Reprinted from the Journal of Manipulative and Physiological Therapeutics with copyright permission from the National University of Health Sciences.

Full text (sometimes free) may be available at these link(s):      help