Investigation of Immediate, Short and Long Term Effects of Mulligan Mobilization With Movement Techniques in Nonspesific Chronic Low Back Pain

Investigation of Immediate, Short and Long Term Effects of Mulligan Mobilization With Movement Techniques in Nonspesific Chronic Low Back Pain: a Randomized Placebo-controlled Trial

Introduction: Although the effectiveness of many mobilization methods in chronic low back pain (CLBP) was shown, these effects were not monitored in the long term. The aim of this study was to identify the immediate, short and long-term effects of mulligan mobilization with movement (MWM) in terms of pain, range of motion (ROM), flexibility, endurance, functionality and disabilities in patients with CLBP. Methods: The study was designed in randomized-placebo controlled with 36 people randomly distributed into 2 groups. Sustained natural apophyseal glide (SNAG) was applied to the lumbar region, straight leg raise (SLR) with traction to the hip, and internal rotational mobilization techniques and home exercise program were applied in Group 1 (n=19); and the same techniques were applied as sham mobilization in Group 2 (n=17). The evaluations were made as post-intervention for immediate effect, and were also made at the 5th week, 3rd month, and 6th months for short and long-term effect. Evaluation was also made for pain in 12th month.

Inclusion Criteria:

• Having 3 months' continuous or intermittent LBP symptoms, without leg pain above the knee
• Pain at VAS > 3/10,
• Back pain increased by active lumbar flexion movement

Exclusion Criteria:

• Confirmed nerve root compression
• Neurological symptoms
• Lumbar spine stenosis
• Back surgery history
• Chronic pain syndrome
• LBP from fracture
• Infection
• Visceral disease
• Pregnancy
• Major clinical depression
• Cauda equina syndrome
• Significant osteoporosis.