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

Study Overview
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Brief Summary
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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.

Official Title
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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

Conditions
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Chronic Low Back Pain

Intervention / Treatment
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* Other: Mulligan mobilization with movement


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Real MWM<br>Real mobilization with movement | Other: Mulligan mobilization with movement<br> <br> |
| Sham Comparator: Sham MWM<br>sham or placebo mobilization with movement | Other: Mulligan mobilization with movement<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Flexibility | Change of lumbar flexibility with sit and reach objective test( cm) | immediate(post intervention)-5 weeeks(after 5 week treatment)-3 months(after 3 months)-6 months(after 6 months) | 
| Endurance | Change of endurance of lumbar extensors with Sorensen endurance test(sn) | immediate(post intervention)-5 weeeks(after 5 week treatment)-3 months(after 3 months)-6 months(after 6 months) | 
| Functionality with patient specific function scale | Change of function | immediate(post intervention)-5 weeeks(after 5 week treatment)-3 months(after 3 months)-6 months(after 6 months) | 
| Disabilities with Oswestry disability index(scale) | Change of disabilities | immediate(post intervention)-5 weeeks(after 5 week treatment)-3 months(after 3 months)-6 months(after 6 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| range of motion with goniometer | change of range of motion | immediate(post intervention)-5 weeeks(after 5 week treatment)-3 months(after 3 months)-6 months(after 6 months)-12 months |