Immediate Effects of Maitland Mobilization and Mulligan Techniques on Flexion and Extension Range of Motion in Patients With Chronic Nonspecific Low Back Pain: A Randomized Pilot Study

Nonspecific Chronic Low Back Pain (NSCLBP) is one of the most common musculoskeletal disorders among different societies. Manual therapists use different approaches for NSCLBP management and or treatment. Comparing manual techniques is a considerable controversial debate among treatment approaches. This study aimed at comparing the immediate effects following Maitland mobilization technique and Mulligan Sustained Natural Apophyseal Glide (SNAG) on flexion and extension in patients with the NSCLBP.
Eighteen volunteers with NSCLBP were randomly divided into three groups: Posteroanterior (PA) mobilization, SNAG, and Sham SNAG. The PA mobilization techniques (Grade III) were performed on prone lying position (four sets of four repetitions; last 30 seconds for each technique). The SNAG techniques were performed accompanying with active flexion in sitting position (four sets of six repetitions). The sham SNAG technique was applied in sitting position while therapist touched gently patients’ backs (three sets of four repetitions). Flexion and extension Range of Motions (ROMs) were measured before and immediately after applied interventions (by inclinometer).
Within group analysis showed significant changes of flexion and extension in ROMs in SNAG and PA mobilization groups. Between groups analysis pointed out significant difference between the SNAG and placebo groups after interventions.
Our results revealed increased flexion ROM following the SNAG technique and increased extension ROM after Maitland PA mobilization. However, our limited sample size might influence final results. More studies with larger sample size will be suggested.