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Advances in Rehabilitation
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vol. 36
Original article

Immediate, short and long-term clinical results of combined Mulligan mobilization with movement techniques in non-specific chronic low back pain: a randomized placebo-controlled trial

Hatice Yakut
Yavuz Yakut
Mahmut Nedim Doral

Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Süleyman Demirel University, Turkey
Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Hasan Kalyoncu University, Turkey
Department of Orthopaedics and Traumatology, Faculty of Medicine, Ufuk University, Turkey
Advances in Rehabilitation, 2022, 36(2), 1–14
Online publish date: 2022/05/16
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1. Vos T, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2017; 390(10100): 1211-59.
2. Konstantinou K, Foster N, Rushton A, Baxter D. The use and reported effects of mobilization with movement techniques in low back pain management; a cross-sectional descriptive survey of physiotherapists in Britain. Man Ther. 2002; 7(4): 206-14.
3. Cleland JA, Fritz JM, Kulig K, Davenport TE, Eberhart S, Magel J, et al. Comparison of the effective-ness of three manual physical therapy techniques in a subgroup of patients with low back pain who satisfy a clinical prediction rule: a randomized clinical trial. Spine. 2009; 34(25): 2720-9.
4. Konstantinou K, Foster N, Rushton A, Baxter D, Wright C, Breen A. Flexion mobilizations with move-ment techniques: the immediate effects on range of movement and pain in subjects with low back pain. J Manipulative Physiol Ther J Manip Physiol Ther. 2007; 3(3): 178-85.
5. Powers CM, Beneck GJ, Kulig K, Landel RF, Fredericson M. Effects of a single session of posterior-to-anterior spinal mobilization and press-up exercise on pain response and lumbar spine extension in people with nonspecific low back pain. Phys Ther. 2008; 88(4): 485-93.
6. Kim G, Lee S, Jeong H. Effects of upper thoracic joint mobilization on dynamic stability of patients with chronic neck pain. J Phys Ther Sci. 2011; 23(5): 753-6.
7. Bialosky JE, George SZ, Horn ME, Price DD, Staud R, Robinson ME. Spinal manipulative therapy – specific changes in pain sensitivity in individuals with low back pain (NCT01168999). J Pain. 2014; 1(2): 136-48.
8. Wong AY, Parent EC, Dhillon SS, Prasad N, Kawchuk GN. Do participants with low back pain who respond to spinal manipulative therapy differ biomechanically from nonresponders, untreated controls or asymptomatic controls? Spine. 2015; 40(17): 1329-37.
9. Lascurain-Aguirrebeña I, Newham D, Critchley DJ. Mechanism of action of spinal mobilizations: a systematic review. Spine. 2016; 41(2): 159-72.
10. Randoll C, Gagnon-Normandin V, Tessier J, Bois S, Rustamov N, O’Shaughnessy J et al. The mechanism of back pain relief by spinal manipulation relies on decreased temporal summation of pain. Neuroscience. 2017; 349: 220-8.
11. Vicenzino B, Paungmali A, Teys P. Mulligan’s mobilization-with-movement, positional faults and pain relief: current concepts from a critical review of literature. Man Ther. 2007; 1(2): 98-108.
12. Moutzouri M, Billis E, Strimpakos N, Kottika P, Oldham JA. The effects of the Mulligan Sustained Natural Apophyseal Glide (SNAG) mobilisation in the lumbar flexion range of asymptomatic subjects as measured by the Zebris CMS20 3-D motion analysis system. BMC Musculoskelet Disor. 2008; 9(1): 131.
13. Warude T, Shanmugam S. The effect of Mckenzie approach and Mulligan’s Mobilisation (SNAGS) in lumbar disc prolapse with unilateral radiculopathy. Int J Sci Res. 2014; 3(10): 59-63.
14. Heggannavar A, Kale A. Immediate effect of modified lumbar SNAGS in non-specific chronic low back patients: a pilot study. Int J Physiother Res. 2015; 3(3): 1018-23.
15. Mulligan BR, Manual Therapy. Published: Plane View Services Wellington, Place, 1999.
16. Hing W, Hall T, Rivett DA, Vicenzino B, Mulligan B, The Mulligan Concept of Manual Therapy-eBook: Textbook of Techniques. Published: Elsevier Health Sciences, Place, 2015.
17. Exelby L. The Mulligan concept: its application in the management of spinal conditions. Man Ther. 2002; 7(2): 64-70.
18. Moutzouri M, Perry J, Billis E. Investigation of the effects of a centrally applied lumbar sustained natural apophyseal glide mobilization on lower limb sympathetic nervous system activity in asymptomatic subjects. J Manipulative Physiol Ther J Manip Physiol Ther. 2012; 35(4): 286-94.
19. Hidalgo B, Pitance L, Hall T, Detrembleur C, Nielens H. Short-term effects of Mulligan mobilization with movement on pain, disability, and kinematic spinal movements in patients with nonspecific low back pain: a randomized placebo-controlled trial. J Manipulative Physiol Ther J Manip Physiol Ther. 2015; 38(6): 365-74.
20. Hussein HM, Morsi AA, Abdelraoof NA. The immediate effect of sustained natural apophyseal glide on postural stability and pain in individuals presenting with flexion-dominant chronic low back pain: A randomized single-blinded placebo-controlled trial. J Back Musculoskelet Rehabil. 2021; 34(6): 1079-83.
21. Anap DB, Khatri S, Zambre B. Effectiveness of sustained natural apophyseal glides and Maitland mobilization in facet joint syndrome: a single blind randomized control pilot study. Int J Health Sci Res. 2014; 4: 142-50.
22. Mellin G. Correlations of hip mobility with degree of back pain and lumbar spinal mobility in chronic low-back pain patients. Spine. 1988; 13(6): 668-70.
23. Barbee Ellison J, Rose SJ, Sahrmann SA. Patterns of hip rotation range of motion: a comparison between healthy subjects and patients with low back pain. Phys Ther. 1990; 70(9): 537-41.
24. Reiman MP, Bolgla LA, Lorenz D. Hip function’s influence on knee dysfunction: a proximal link to a distal problem. J Sport Rehabil. 2009; 18(1): 33-46.
25. Oja P, Tuxworth B. Eurofit for adults: A test battery for the assessment of the health-related fitness of adults. Strassbourg: Council of Europe, Committee for the Development of Sport. 1995, 134-89.
26. Hui S-C, Yuen PY. Validity of the modified back-saver sit-and-reach test: a comparison with other protocols. Med Sci Sports Exerc. 2000; 32(9): 1655-9.
27. Yakut E, Düger T, Öksüz Ç, Yörükan S, Üreten K, Turan D et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine. 2004; 2 (5): 581-5.
28. Fairbank JC, Pynsent PB. The Oswestry disability index. Spine. 2000; 25(22): 2940-53.
29. Latimer J, Maher CG, Refshauge K, Colaco I. The reliability and validity of the Biering–Sorensen test in asymptomatic subjects and subjects reporting current or previous nonspecific low back pain. Spine. 1999; 2(20): 2085.
30. Maughan EF, Lewis JS. Outcome measures in chronic low back pain. Eur Spine J. 2010; 19(9): 1484-94.
31. Boonstra AM, Preuper HRS, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008; 3(2): 165-9.
32. Norkin CC, White DJ. Measurement of joint motion: a guide to goniometry. Published: FA Davis, Place, 2016.
33. Senna MK, Machaly SA. Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome? Spine. 2011; 36(18): 1427-37.
34. Mulligan BR, Manual Therapy. Published: Optp, Place, 2004.
35. Weerasekara I, Osmotherly P, Snodgrass S, Marquez J, de Zoete R, Rivett DA. Clinical benefits of joint mo-bilization on ankle sprains: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2018; 99(7): 1395-412.
36. Rubinstein SM, De Zoete A, Van Middelkoop M, Assendelft WJ, De Boer MR, Van Tulder MW. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ. 2019; 364l689.
37. Stathopoulos N, Dimitriadis Z, Koumantakis GA. Effectiveness of Mulligan’s mobilization with movement techniques on pain and disability of peripheral joints: a systematic review with meta-analysis between 2008–2017. Physiotherapy. 2019; 105(1): 1-9.
38. Pourahmadi MR, Mohsenifar H, Dariush M, Aftabi A, Amiri A. Effectiveness of mobilization with movement (Mulligan concept techniques) on low back pain: a systematic review. Clin Rehabil. 2018; 32(10): 1289-98.
39. Hussien HM, Abdel-Raoof NA, Kattabei OM, Ahmed HH. Effect of Mulligan concept lumbar SNAG on chronic nonspecific low back pain. J Chiropr Med. 2017; 16(2): 94-102.
40. Waqqar S, Shakil-ur-Rehman S, Ahmad S. McKenzie treatment versus mulligan sustained natural apophyseal glides for chronic mechanical low back pain. Pak J Med Sci. 2016; 32(2): 476.
41. Tambekar N, Sabnis S, Phadke A, Bedekar N. Effect of Butler’s neural tissue mobilization and Mulligan’s bent leg raise on pain and straight leg raise in patients of low back ache. J Bodyw Mov Ther. 2016; 20(2): 280-5.
42. Rajalaxmi V, Veena S. Effectiveness of mulligan’s two leg raise and bent leg raise techniques in subjects with acute non-specific low back pain in improving hamstring flexibility. Int J Physiother Res. 2015; 1(2): 29-36.
43. Hoffman SL, Johnson MB, Zou D, Van Dillen LR. Differences in end-range lumbar flexion during slumped sitting and forward bending between low back pain subgroups and genders. Man Ther. 2012; 17(2): 157-63.
44. Reid SA, Rivett DA, Katekar MG, Callister R. Sustained natural apophyseal glides (SNAGs) are an ef-fective treatment for cervicogenic dizziness. Man Ther. 2008; 13(4): 357-66.
45. Clark BC, Thomas JS, Walkowski SA, Howell JN. The biology of manual therapies. J Am Osteopath Assoc. 2012; 112(9): 617-29.
46. Yadav S, Nijhawan MA, Panda P. Effectiveness of spinal mobilization with leg movement (SMWLM) in patients with lumbar radiculopathy (L5/S1 nerve root) in lumbar disc herniation. Int J Physiother Res. 2014; 2(5): 712-8.
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