Low Back Pain
Conditions
Keywords
mulligan, maitland, proprioception, low back pain
Brief summary
this study will be conducted to compare between the effect of mulligan mobilization versus Maitland mobilization on pain ,function and lumbar proprioception in patients with chronic nonspecific low pain
Detailed description
Low back pain (LBP) is considered as one of the most widespread musculoskeletal disorders, impacting over 80% of the world's population, resulting in work absence, medical consultation, a decline in quality of life, and financial burden. Lumbar repositioning error was high around 30° of trunk flexion in individuals with CLB. When lumbar proprioceptive deficiencies arise, the activation pattern of back muscles is disturbed, the mechanics of the spinal unit differs from that of a healthy spine, and the recurrence rate of LBP increases . CLBP is managed using various intervention modalities, including drug therapy and physical therapy approaches . Physical therapy modalities, such as manual therapy, therapeutic exercises, and biopsychosocial techniques, are used for treating LBP. Manual therapy is a common and suggested modality for treating CLBP that has strong evidence. It is employed in physical therapy practice, including Maitland mobilization and Mulligan mobilization. Mulligan mobilization as well as Maitland mobilization has significant effect on pain ,function disability and lumbar repositioning error. But there is gap about which is more beneficial. So we conduct this study to determine which technique is more beneficial for patients
Interventions
OTHERmulligan group
SNAG technique was applied from a sitting position on the edge of the table while both feet were on a foot rest. A specialized Mulligan belt was used around the patient's waist and therapist's hips. The mobilizing force was applied parallel to the facet joint plane (cephalic direction) and over the spinous processes of the respective symptomatic spinal levels. The patients were asked to lean forward as much as possible during application of the mobilizing force and then return to the starting position while the therapist maintained his mobilizing force until the end. plus traditional therapy
The subjects were placed in the prone position on a plinth with their hands beside them, and the therapist stood on the subject's side, the ulnar surface of the hand (between pisiform and hamate) was placed over the hypomobile spinous process. The second hand was placed on top of the first to enhance its force. With the therapist's elbows slightly bent and shoulders exactly above the spinous process, an oscillatory movement of the vertebra was executed by applying a posterior-anterior force to the hypomobile or painful spinous process. Grade III mobilization was applied four times, each with 60 s of oscillation and 20 s of rest in between them (2 or 3 oscillations per second) plus traditional therapy
OTHERtraditional therapy
the patients will receive traditional therapy in the form of passive stretching, strengthening, and lumbar stabilization exercises
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
opaque sealed envelope
Intervention model description
mulligan and maitland parallel group
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* They had interrupted or continuous LBP symptoms for more than 3 months * both gender
Exclusion criteria
* specific LBP * those who were pregnant * those with neurological problems
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| joint position error (lumbar proprioception) | up to four weeks | joint position error will be measured by isokinetic. The lumbar Joint Position Error (JPE) Test is a measurement tool used to clinically assess an individual's lumbarcephalic proprioception ability. proprioception describes one's sense of position of their back in space. The lumbar JPE Test measures the ability of a blindfolded patient to accurately relocate their lumbar to a predetermined neutral point after lumbar joint movement. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| pain intensity | up to four weeks | pain intensity will be measured by VAS. The VAS is a 10-cm horizontal line and has two ends-one end expresses no pain on the left side and the second end expresses maximal pain on the right side |
| Functional disability | up to four weeks | The Arabic version of the Oswestry Disability Index (ODI) was used to assess functional level. The ODI is a 10-item questionnaire, with each item answered using a 6-point Likert scale, ranging from 0 to 5. Pain severity, self-care, sitting, lifting, sleeping, walking, traveling, sexual life (if founded), and sociality are all items considered by the ODI.The point total from each section is summed, divided by the total points possible of all sections answered, and multiplied by 100 to create a percentage disability from 0-100%, with a lower percentage indicating less disability. |
| lumbar range of motion | up to four weeks | range of motion will be measured by tape measurement |
Countries
Egypt
Outcome results
None listed