Mulligan Sustained Natural Apophyseal Glides Versus McKenzie Method in Patients With Non-Specific Chronic Low Back Pain
Condition: Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      Low back pain (LBP) is the most frequent complaint encountered in clinical practice.
      Exercises and manual therapy prescription are common physical therapy treatments prescribed
      for the patients presenting with chronic low back pain. The interventions will establish the
      future direction for practitioners in choosing the manual therapy or repeated exercises as
      effective prescription and provide a basis for future research
    

Detailed description: 
      A variety of treatment interventions, modalities and techniques are used in physical therapy
      management of non-specific low back pain including manual therapy, exercises, neural
      mobilizations, stretching soft tissue techniques and dry needling etc. Out of these more
      recent literature supports manual therapy, self exercises, patient counseling and awareness
      have been recommended in back pain management guidelines, in the United States and is also
      frequently used in clinical practice in various countries.

      Despite multiple theoretical frame works proposing the role of SNAGs and MDT mobilizations
      and exercises respectively, the literature on the true mechanism of direct or indirect
      physiological effects of these on performance or performance-related outcomes is vague and
      lacks justifiable procedural rigor.

      The results of this study will provide information regarding the direction for practitioners
      in choosing the manual therapy or repeated exercises as effective prescription and provide a
      basis for future research.
    

Intervention name(s): Mulligan Sustained Natural Apophyseal Glide (SNAG); McKenzie Method; Conventional Physical Therapy
Intervention type(s): Other; Other; Other
Intervention description(s): Application of the MWM technique developed by Brian R. Mulligan. The clinical researcher will perform and holds sustained passive segmental glide at the target joint maintaining the slack whereas the patient will actively move in the direction of pain or stiffness. These MWM techniques when applied to spinal segments or joint is called sustained natural apophyseal glide (SNAG).; An active therapy technique involving repeated movements or sustained positions along with an educational component prescribed to the patient for of minimizing the pain and disability and increase the spinal range of motion. The method will involve the assessment of symptomatic and mechanical responses to repeated movements and sustained positions in the direction of preference. The method will be used for assessment and treatment of patients and with derangement syndrome.; It includes usual physical therapy care such as Therapeutic Ultrasound, Moist Heat-pack, TENS and standard exercises.
Other intervention name(s): Mulligan Mobilization; Mechanical Diagnosis and Therapy (MDT)
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participants will be randomized to three study arms and each study arm will be allocated a different intervention
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Non-specific Low Back Pain; Sustained Natural Apophyseal Glide; McKenzie Method; Mechanical Diagnosis and Therapy; Range of Motion; Pain; Functional Disability; Fear Avoidance Beliefs