None listed
Conditions
Brief summary
This study will be conducted in accordance with ethical principles and guidelines for research involving human participants. Ethical approval will be obtained from the Research and Ethics Committee of Universiti Kebangsaan Malaysia before the commencement of the study Hypothesis: It is hypothesized that participants receiving Mulligan Sustained Natural Apophyseal Glides (SNAGs) combined with usual physiotherapy care will demonstrate greater improvements in pain, physical function, and disability compared to those receiving physiotherapy care alone. Intervention and Activities: The intervention group will receive therapist-applied SNAGs targeting the lumbar spine twice weekly for four weeks, followed by 10 minutes of supervised self-SNAGs. All participants, including the control group, will undergo a standard physiotherapy program comprising core strengthening exercises, stretching, and education on posture and ergonomics. Sessions will be conducted by qualified physiotherapists, with progress monitored weekly. Outcome measures such as pain scores, disability levels, and functional mobility will be assessed pre- and post-intervention.
Interventions
Experimental Group (SNAGs [Passive & Self] + Rehabilitation Exercises)
-Participants in the experimental group will undergo a total of 4 weeks of physiotherapy.
-Each participant will attend two supervised sessions per week (a total of 8 sessions over 4 weeks) at Physio Pro Rehabilitation Centre.
During each session:
-Participants will first receive Mulligan Sustained Natural Apophyseal Glides (SNAGs) applied to the lumbar spine, administered by a trained physiotherapist (approximately 20 min
Experimental Group (SNAGs [Passive & Self] + Rehabilitation Exercises) -Participants in the experimental group will undergo a total of 4 weeks of physiotherapy. -Each participant will attend two supervised sessions per week (a total of 8 sessions over 4 weeks) at Physio Pro Rehabilitation Centre. During each session: -Participants will first receive Mulligan Sustained Natural Apophyseal Glides (SNAGs) applied to the lumbar spine, administered by a trained physiotherapist (approximately 20 minutes). -This will be followed by 10 minutes of supervised self-SNAG techniques, where participants are guided in performing SNAGs independently under supervision. -Subsequently, participants will engage in usual physiotherapy care, which consists of a structured rehabilitation exercise program focusing on core stabilization, flexibility, and functional movement exercises (approximately 15 minutes). -Each supervised physiotherapy session is anticipated to take approximately 45 minutes in total. -In addition to the supervised sessions, participants will be instructed to perform daily self-SNAGs at home as part of their home exercise program, ensuring continuity of care between sessions. This combined intervention of passive and self-administered SNAGs along with rehabilitation exercises is delivered concurrently within the same 4-week treatment period.
Sponsors
KOGILAVANI SHAGER (NATIONAL UNIVERSITY OF MALAYSIA)
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
I. Adults aged 18 to 65 years. II. Participants must be diagnosed with CNSLBP, defined as lower back pain persisting for more than 12 weeks without an identifiable pathological cause (e.g., infections, fractures, tumors, or inflammatory conditions). III. The diagnosis will be made by a licensed medical practitioner or physiotherapist with expertise in musculoskeletal conditions. IV. Baseline pain score of at least 3/10 on the Visual Analog Scale (VAS). V. Willingness to comply with study protocols and attend follow-up sessions.
Exclusion criteria
I. History of specific lower back pathology (e.g., infections, fractures, tumors, or inflammatory conditions). II. Previous spinal surgery within the past year. III. Significant neurological deficits or red flag signs (e.g., cauda equina syndrome). IV. Pregnant women and individuals with severe comorbid conditions that could interfere with participation. V. Participants with osteoporosis confirmed by a medical diagnosis or risk factors such as prolonged corticosteroid use VI. Participants who have received an intrathecal lumbar injection within the past 3 months, as this could affect pain perception and treatment outcomes.
Outcome results
None listed