Chronic Low-back Pain
Conditions
Keywords
Chronic Low Back Pain, Physiotherapy, Mulligan, Instrument Assisted Manipulation, Core Exercise
Brief summary
We aimed to investigate the effects of instrument assisted manipulation (IAM) and Mulligan mobilization with movement (MWM) on joint range of motion (ROM), pain, proprioception, endurance, back awareness and disability in individuals with chronic non-specific low back pain (CNSLBP). Fifthy one participants were randomly divided into 3 groups. The first was the Mulligan group, the second was the IAM group, and the third was the core exercise group. Visual Analogue Scale (VAS) was used to assess pain severity. Lumbal flexibility was evaluated with the fingertip-to-floor test. Oswestry disability index (ODI) and Roland Morris Disability Questionnaire (RMDQ) used to evaluate the disability. Fremantle back awareness questionnaire (FBAQ) used to evaluate back awareness. Joint ROM (lumbal flexion, lumbal extension and lumbal lateral flexion) and proprioception (30° lumbal flexion in standing, 30° lumbal flexion in sitting, 15° lumbal extension standing and lumbal neutral position) evaluated with JTECH digital dual inclinometer. McGill core endurance tests were used for core endurance assessment. McGill core endurance assessment consists of 3 tests. These: Flexor endurance test, lateral endurance test and extensor endurance test.
Detailed description
IAM and Mulligan MWM interventions were applied 3 days a week for 2 weeks in total 6 sessions. All 3 groups did same core exercise program. The exercise program was done from the baseline for 6 weeks, 3 days a week, for a total of 18 sessions. Outcome measurements were done at baseline, at the end of the 2nd week, and at the end of the 6th week. The researcher who performed the outcome measurements did not know the participant's group. Assessment and treatment were performed by two different researchers with 8 years of professional experience. Visual Analogue Scale (VAS) was used to assess pain severity. Lumbal flexibility was evaluated with the fingertip-to-floor test. Oswestry disability index (ODI) and Roland Morris Disability Questionnaire (RMDQ) used to evaluate the disability. Fremantle back awareness questionnaire (FBAQ) used to evaluate back awareness. Joint ROM (lumbal flexion, lumbal extension and lumbal lateral flexion) and proprioception (30° lumbal flexion in standing, 30° lumbal flexion in sitting, 15° lumbal extension standing and lumbal neutral position) evaluated with JTECH digital dual inclinometer. The measurement of the joint ROM in the lumbal region with the dual inclinometer technique is a reliable method. McGill core endurance tests were used for core endurance assessment. McGill core endurance assessment consists of 3 tests. These: Flexor endurance test, lateral endurance test and extensor endurance test.
Interventions
OTHERInstrument assisted manipulation + Core exercises
The effect of Instrument assisted manipulation on chronic non-spesific low back pain
OTHERMulligan mobilization with movement + Core exercises
The effect of Mulligan mobilization with movement on chronic non-spesific low back pain
OTHERCore exercises
The effect of core exercises on chronic non-spesific low back pain
Sponsors
Tokat Gaziosmanpasa University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Intervention model description
Randomized Controlled Trial
Eligibility
Sex/Gender
ALL
Age
20 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* LBP for at least 3 months * Diagnosis of non-specific LBP * 20-55 ages.
Exclusion criteria
* Red flag symptoms related to LBP * Neurological findings * Pain radiating to the leg * Undergone spinal surgery * Pathology of the spine (fracture, tumor, spondylolisthesis, spinal stenosis, cauda equina syndrome).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline visual analogue scale at 2nd and 6th weeks | Baseline, 2nd week, 6th week | Pain assessment. The minimum score of the visual analogue scale is 0, and the maximum score is 10. Higher scores indicate worse outcome. |
| Change from baseline fingertip-to-floor test at 2nd and 6th weeks | Baseline, 2nd week, 6th week | Lumbal flexibility |
| Change from baseline joint ROM measurement with digital inclinometer at 2nd and 6th weeks | Baseline, 2nd week, 6th week | Lumbal flexion, lumbal extension and lumbal lateral flexion |
| Change from baseline proprioception measurement with digital inclinometer at 2nd and 6th weeks | Baseline, 2nd week, 6th week | 30° lumbal flexion in standing, 30° lumbal flexion in sitting, 15° lumbal extension standing and lumbal neutral position |
| Change from baseline Oswestry disability index at 2nd and 6th weeks | Baseline, 2nd week, 6th week | Disability assessment. The minimum score of the Oswestry disability index is 0, and the maximum score is 50. Higher scores indicate worse outcome. |
| Change from baseline Roland Morris disability questionnaire at 2nd and 6th weeks | Baseline, 2nd week, 6th week | Disability assessment. The minimum score of the Roland Morris disability questionnaire is 0, and the maximum score is 24. Higher scores indicate worse outcome. |
| Change from baseline Fremantle back awareness questionnaire at 2nd and 6th weeks | Baseline, 2nd week, 6th week | Back awareness assessment. The minimum score of the Fremantle back awareness questionnaire is 0, and the maximum score is 36. Higher scores indicate worse outcome. |
Countries
Turkey (Türkiye)
Outcome results
None listed