Immediate Effect of Two Selected Mulligan Techniques in Nonspecific Low Back Pain

Sponsor

Cairo University (Other)

Overall Status

Recruiting

CT.gov ID

NCT05856279

Collaborator

(none)

Enrollment

Location

Arms

3.4

Anticipated Duration (Months)

11.6

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

To compare between immediate effect of SNAG and mulligan lion position in range of motion (ROM) , pain, functional ability and kinesiophobia on patients with nonspecific low back pain.

Condition or Disease	Intervention/Treatment	Phase
Back Pain	Procedure: mulligan SNAG and mulligan lion position	N/A

Detailed Description

Low back pain (LBP) is a global health problem.Orthopedic Manual therapy (OMT) is most commonly recommended form of treatment of LBP and it is also frequently used in clinical practice in various countries. Mulligan introduced a new technique in manual therapy. Mulligan has a great role in the treatment of LBP.General techniques of mulligan are MWM, SNAGs and natural apophyseal glides (NAGs).

Lumber SNAG have immediate and short term on pain and function in treatment of patients with NSLBP.Mulligan has special techniques, one of them is modified lumbar SNAG (lion position) .It has short term effect in reducing pain and activity limitation. Up to investigated knowledge, No previous studies comparing immediate effect of two techniques in range of motion (ROM), pain, functional ability and kinesiophobia

Study Design

Study Type:

Interventional

Anticipated Enrollment :

40 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Intervention Model Description:

mulligan SNAG and mulligan lion positionmulligan SNAG and mulligan lion position

Masking:

Double (Participant, Outcomes Assessor)

Masking Description:

Double blinded clinical randomized controlled trial (research assistant for assessment and patients will be blinded to about treatment).

Primary Purpose:

Treatment

Official Title:

Immediate Effect of Two Selected Mulligan Techniques on Lumbar Sagittal Mobility in Nonspecific Low Back Pain

Actual Study Start Date :

Jan 16, 2023

Anticipated Primary Completion Date :

May 1, 2023

Anticipated Study Completion Date :

May 1, 2023

Arms and Interventions

Arm	Intervention/Treatment
Experimental: mulligan SNAG Patients in this group will receive mulligan SNAG from sitting position and McGill stabilization exercises.The glide will be performed six repetitions for three sets for one session and McGill stabilization exercises as a home program: 7 days a week and 10 repetitions of each exercise for 2times per day and a rest interval of 2 minutes between exercises	Procedure: mulligan SNAG and mulligan lion position manual therapy techniques for lumbar spine Other Names: moblization with movement
Experimental: mulligan lion position Patients in this group will receive mulligan modified lumbar SNAG lion position and McGill stabilization exercises.Modified lumbar SNAGs (lion position) will be applied in a quadruped position (lion position)six repetitions for three sets for one session . McGill stabilization exercises as a home program: 7 days a week and 10 repetitions of each exercise for 2times per day and a rest interval of 2 minutes between exercises The therapist stands to one side of the patient and applies (SNAG) centrally to the spinous process of the involved segment. The medial border of the hand is hooked under the chosen segment while the other arm encircles the trunk to stabilize the upper body. The therapist maintains the glide while the patient sits back towards their heels (for flexion) .	Procedure: mulligan SNAG and mulligan lion position manual therapy techniques for lumbar spine Other Names: moblization with movement

Arm

Intervention/Treatment

Experimental: mulligan SNAG

Patients in this group will receive mulligan SNAG from sitting position and McGill stabilization exercises.The glide will be performed six repetitions for three sets for one session and McGill stabilization exercises as a home program: 7 days a week and 10 repetitions of each exercise for 2times per day and a rest interval of 2 minutes between exercises

Procedure: mulligan SNAG and mulligan lion position

manual therapy techniques for lumbar spine

Other Names:

moblization with movement

Experimental: mulligan lion position

Patients in this group will receive mulligan modified lumbar SNAG lion position and McGill stabilization exercises.Modified lumbar SNAGs (lion position) will be applied in a quadruped position (lion position)six repetitions for three sets for one session . McGill stabilization exercises as a home program: 7 days a week and 10 repetitions of each exercise for 2times per day and a rest interval of 2 minutes between exercises The therapist stands to one side of the patient and applies (SNAG) centrally to the spinous process of the involved segment. The medial border of the hand is hooked under the chosen segment while the other arm encircles the trunk to stabilize the upper body. The therapist maintains the glide while the patient sits back towards their heels (for flexion) .

Procedure: mulligan SNAG and mulligan lion position

manual therapy techniques for lumbar spine

Other Names:

moblization with movement

Outcome Measures

Primary Outcome Measures

ROM [up to 2 hours after technique]
ROM by bubble inclinometer

Secondary Outcome Measures

degree of Pain [one week]
Pain will be assessed by VAS.

Other Outcome Measures

Functional disability [one week]
Functional disability will be assessed by the arabic version of Oswestry
Kinesiophobia [one week]
Kinesiophobia will be assessed Tampa scale -Arabic version

Eligibility Criteria

Criteria

Ages Eligible for Study:

20 Years to 40 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

3 to 7 on VAS.
Back Pain duration of 6 week or more .
20-40 years old .
Patients of both sexes will be concluded .
body mass index (18.5-29.9 KG/M2).

Exclusion Criteria:

fracture, osteoporosis, myelopathy, multiple adjacent radiculopathies, cauda equina syndrome, vertebral bone disease and bony joint instability .
Infective conditions of spine, autoimmune disorders, Pacemakers, malignancy .
History of surgery or injection at lumbar spine 1 year ago .