Mulligan Technique Versus McKenzie Extension Exercise Chronic Unilateral Radicular Low Back Pain
Condition: Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      This project will be a Randomized clinical trial conducted to determine effects of Mulligan
      technique versus McKenzie extension exercise with manual traction in patients with chronic
      unilateral radicular low back pain. Sample will be collected through non-probability
      convenient sampling, following eligibility criteria from Rehab Care and Jinnah Hospital
      Lahore. Eligibility criteria will be both gender and age range 28-50 years, clinically
      diagnosed patient with Lumbar radiculopathy after exclusion of the patients with Fracture,
      Trauma, Inflammatory disorder, acute disc bulge, Lumbar instability. Participants will be
      randomly allocated in two groups via sealed envelope method, baseline assessment will be
      done, Group A participants will be given baseline treatment along with Mulligan techniques,
      Group B participants will be given baseline treatment along with McKenzie protocol. Pre and
      post intervention assessment will be done via, Numeric pain rating scale(NPRS), Oswestry
      Disability Scale (ODI) and lumber Range of Motion, 2 sessions per week will be given for 4
      weeks, data will be analyzed by using SPSS version 29.
    

Detailed description: 
      Chronic mechanical low back pain is common among different age groups and genders. Different
      manual therapy techniques combined with exercise therapy and electrotherapy modalities play
      an important role in its management. Our objective was to compare the effects of McKenzie
      extension exercises program versus Mulligan Techniques for chronic unilateral radicular low
      back pain. The primary objective of my study is to evaluate the outcome of Mulligan technique
      versus McKenzie extension exercise with manual traction in patients with chronic unilateral
      radicular low back pain in terms of pain reduction and ROM.

      A randomized control trial will be conducted at Rehab Care and Jinnah Hospital Lahore, from
      1st June - 31st January 2024. Both genders and age range 28-50 years clinically diagnosed
      patient with Lumbar radiculopathy will be included. The patients with Fracture, Trauma,
      Inflammatory disorder, acute disc bulge, Lumbar instability will be excluded. Subjects will
      be divided into two equal groups through a computer-generated random number. Sixteen patients
      in group A will be treated with Mulligan techniques and Sixteen patients in group B with
      McKenzie for four weeks at two session per week and single session per day. Visual Analogue
      Scale, Oswestry Disability Scale and lumbar Range of Motion will be used as an assessment
      tool and were measured at baseline and at the completion 4 weeks intervention. The data will
      be entered and analyzed with SPSS to draw the statistical and clinical significance of both
      interventions. Results will be presented as mean and standard deviation for numerical
      variables like Visual Analogue Scale, Oswestry Disability Scale and lumber Range of Motion.
      Analysis will be done by statistical package for social sciences SPSS 29
    

Intervention name(s): Mulligan techniques with manual traction; McKenzie extension exercises with manual traction
Intervention type(s): Other; Other
Intervention description(s): group A will be treated with Mulligan techniques with manual traction.16 patients in group A will be treated with Mulligan Techniques SNAGS in sitting, standing and prone position by applying Antero cranial glide in the direction of treatment plane over the spinous or transverse process and Spinal mobilization with leg movement at 6 to 8 repetitions per sessions and spinal mobilization with leg movement will be performed in side lying, patient facing the physiotherapist while the leg movement may assisted by another person (Physiotherapist/assistant). Sustained transverse glide is given on the desired spinous process with 10 repetitions of offending movement in first session while 10 reps in each of 3 sets in further sessions.; group B will be treated McKenzie extension exercises with manual traction.16 patients in group B will be treated with McKenzie active EEP in prone position with repeated movements along with standard protocols. McKenzie Extension Exercises performed actively in prone position. Extension exercises performed in three stages, initially patient instructed to be just lift the neck and look on front at the eye level, then progressed next and weight bearing on the elbow by lifting up the shoulder and then moved on third and final steps in which complete trunk extension is performed and weight bearing is on the hands.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Low Back Pain; Range of Motion; Manual Therapy; Pain; Mobilization