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

doi:10.5114/areh.2022.116369

Figures & Tables

a – Lumbar SNAG (Sponge was not used to see finger placement clearly), b – Hip internal rotation with traction, c – Traction SLR method

CONSORT Flow Diagram Design demonstrating patient recruitment and timing of data collection of treatment groups

Changes in Pain values for Real MWM and Sham MWM p < 0.05 statistically significant; α: Significant difference at baseline; β: Significant difference at post-intervention; γ: Significant difference at 5 weeks; δ: Significant difference at 3 months.

Changes in Hip İnternal Rotation, Hip Flexion, Lumbar Flexion and SLR ROM values for Real MWM and Sham MWM p < 0.05 statistically significant; α: Significant difference according to baseline; β: Significant difference according to post-intervention; γ: Significant difference according to 5weeks; δ: Significant difference according to 3months.

Intergroup and intragroup differences from baseline to six-month follow-up

Measures		Baseline	Post-int.	5 weeks	3 months	6 months

		Mean ± SD Med (min–max)	Mean ± SD Med (min–max)	Mean ± SD Med (min–max)	Mean ± SD Med (min–max)	Mean ± SD Med (min–max)	Intragroup p
SRT	Real MWM	–10.04 ± 13.33 –8.75 (−53–8)	–6.69 ± 13.37 –6.25 (−50–13)	−0.72 ± 10.48 αβ 1 (−22–15)	–2.33 ± 9.28 α 0 (−19–12)	–2.19 ± 8.9 α 0 (−17–12)	< 0.0001 (Fr = 35.425)
SRT	Sham MWM	−0.57 ± 10.18 –0.75 (−17–19)	0.57 ± 9.72 –0.25 (−16–19)	−0.64 ± 9.02 0 (−17–17)	0.3 ± 8.76 –1 (−15–19,2)	−0.71 ± 8.86 –2 (−16–19)	0.588 (F = 0.711)
Intergroup p		0.033^* (z = −2.126)	0.138 (z = −1.507)	0.832 (t=0.214)	0.324 (t = −1.002)	0.643 (t = −0.468)

R-LBT	Real MWM	19.08 ± 4.5 19 (10–27)	20.16 ± 4.67 20.5 (8.5–32)	22.14 ± 3.56 α 21.25 (16–30)	21.67 ± 2.45 21.5 (16–25.5)	20.5 ± 3.81 20 (10–26)	<0.01 (Fr = 13.192)
R-LBT	Sham MWM	18.29 ± 4.03 17.5 (12–25)	18.14 ± 3.25 17.25 (12–24)	19.46 ± 3.34 19 (15–26)	19.82 ± 3.59 20 (12–27)	19.14 ± 3.44 19 (14–25)	0.223 (Fr = 5.696)
Intergroup p		0.466 (t = 0.738)	0.1 (t = 1.69)	0.038^* (z = −2.067)	0.034^* (t = 2.219)	0.305 (t = 1.043)

L-LBT	Real MWM	17.92 ± 4.44 17.75 (8–27)	20.19 ± 4.78 19.75 (8–31)	22.25 ± 3.56 α 22 (13 – 28)	21.97 ± 3.15 α 22.5 (13–27.5)	21.56 ± 4.53 α 20.5 (12–33)	<0.0001 (Fr = 26.071)
L-LBT	Sham MWM	19.04 ± 2.99 19 (15–25)	19.13 ± 2.84 18.5 (14–25)	19.14 ± 3.54 18.75 (14–24.5)	19.39 ± 4.12 20 (9.5–27)	18.93 ± 2.62 18 (15–24)	0.786 (Fr = 1.728)
Intergroup p		0.716 (t = −0.367)	0.244 (t = 1.185)	0.005^* (t = 2.987)	0.026 ^* (t = 2.33)	0.063 (t = 1.931)

SOR	Real MWM	20.67 ± 15.92 15 (7–65)	27.5 ± 17.55 23 (7–65)	35.28 ± 15.63 α 31 (13–65)	40.22 ± 16.77 αβ 40 (13–70)	40 ± 17.93 α 35 (13–90)	< 0.0001 (Fr = 30.257)
SOR	Sham MWM	23.21 ± 18.44 15.5 (6–63)	25.93 ± 20.23 16 (5–64)	34.5 ± 19.5 α 38.5 (8–61)	35.36 ± 22.46 31.5 (7–80)	34 ± 21.97 31 (7–80)	0.005 (Fr = 15.026)
Intergroup p		0.257 (z = −1.142)	0.208 (z = −1.285)	0.384 (t = 0.884)	0.278 (t = 1.103)	0.401 (t = 0.851)

ODI	Real MWM	43.37 ± 14.35 40 (22–72)	–	21.64 ± 13.07 α 20 (6–48)	13.11 ± 10.5 αγ 10 (0–42)	12.39 ± 11.08 αγ 10 (0–34)	<0.0001 (F = 62.658)
ODI	Sham MWM	35.86 ± 20.18 37 (8–72)	–	34.29 ± 22.02 24 (4–72)	24.68 ± 14.13γ 20 (2–53)	24.93 ± 11.94γ 21 (2–50)	0.028 (Fr = 9.112)
Intergroup p		0.813 (t = 0.238)	–	0.015^* (z = −2.432)	0.004^* (t = −3.151)	0.005^* (t = −3.07)

PSFS	Real MWM	20.39 ± 4.1 20 (14–28)	–	9.28 ± 5.51 8 (0–18)	3.61 ± 4.16 αγ 2 (0–12)	2.83 ± 3.29 αγ 2 (0–10)	< 0.0001 (Fr = 51.144)
PSFS	Sham MWM	19.93 ± 6.21 21 (11–30)	–	14.57 ± 7.42 α 15 (0–27)	10.93 ± 6.07 αγ 11,5 (0 – 21)	10.21 ± 6.44 αγ 9.5 (0–28)	<0.0001 (F = 15.576)
Intergroup p		0.756 (t = 0.313)	–	<0.01 (t= −2.739)	< 0.0001 (z = −3.47)	< 0.0001 (z = −3.545)

Anthropometric data and outcome variables at baseline

Parameter	Real MWM (n = 19)	Sham MWM (n = 17)	t	p

	Mean ± SD	Mean ± SD
Age (years)	36.4 ± 11.3	41.8 ± 10.1	–1.494	0.144
BMI (kg/m²)	24.4 ± 3.3	26.5 ± 5.5	–1.401	0.170
Height (cm)	163.84 ± 6.14	163.24 ± 7.24	0.272	0.787
Weight (kg)	66.08 ± 10.18	72.76 ± 11.94	–1.813	0.079
LBP duration (months)	7.4 ± 8.8	4.7 ± 5.2	–2.435	0.021^*
Pain at rest (VAS)	6.2 ± 1.9	6.4 ± 2.0	−0.221	0.826
ODI	43.37 ± 14.35	35.86 ± 20.18	0.238	0.813
Number of male/female	4/15	3/14	–	–
Number of painful side right/left	11/8	8/9	–	–

Schedule of assessments

Outcome measures	Pre-treatment (baseline)	Post intervention (immediate)	After 5^th week (short-term)	After 3^rd month (long-term)	After 6^th month (long-term)	After 12^th month (long-term)
SRT	√	√	√	√	√	–
LBT	√	√	√	√	√	–
SOR	√	√	√	√	√	–
ODI	√	–	√	√	√	–
PSFS	√	√	√	√	√	–
ROM	√	√	√	√	√	–
Pain	√	√	√	√	√	√

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

Figures & Tables

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Fig. 4.

Intergroup and intragroup differences from baseline to six-month follow-up

Anthropometric data and outcome variables at baseline

Schedule of assessments

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