Effects of Sustained Natural Apophyseal Glides in Combination With McKenzie Extension Protocol in the Management of Discogenic Low Back Pain

Study Overview
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Brief Summary
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Lumbar degenerative disc disease and discogenic low back pain is comparatively common and disabling musculoskeletal condition. McKenzie's extension protocol is considered to be the gold standard physical therapy treatment for persons with acute discogenic low back pain, however the evidence is deficient in terms of additive benefits of sustained natural apophyseal glides in the management of discogenic low back pain. Thus, the current study will not only look into the positive effects of McKenzie's extension protocol in the management discogenic low back pain, but will also look into the additive benefits of sustained natural apophyseal glides in combination with McKenzie's extension protocol in the management of discogenic low back pain.

Official Title
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Effects of Sustained Natural Apophyseal Glides (SNAGs) in Combination With McKenzie Extension Protocol (Mechanical Diagnostic Therapy) in the Management of Discogenic Low Back Pain

Conditions
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Low Back Pain, Disk Prolapse, Disk Herniated Lumbar, Sciatic Radiculopathy

Intervention / Treatment
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* Procedure: Mckenzie Extension Protocol
* Procedure: Lumbar SNAGs
* Device: inferential therapy
* Device: Heat Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Both male and female participants aged 18-50 years old low back pain intensity less than 80/100mm on visual analogue scale positive centralization phenomenon low signal intensity of IV disc on T2 - weighted MRI high intensity zone towards the posterior aspect of the disc on MRI Exclusion Criteria: Individuals with and any musculoskeletal, metabolic, or neurological disorders that may impair gait, postural stability or sensory integrity will be excluded from the study. -

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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental Group<br> | Procedure: Mckenzie Extension Protocol<br>* Mckenzie Extension Exercise Protocol will be performed by participants in prone position<br>Procedure: Lumbar SNAGs<br>* Lumbar SNAGs will be performed in lumbar flexion and extension in standing Position<br>Device: inferential therapy<br>* 4 pole inferential therapy in combination with superficial heating for 20 minutes<br>Device: Heat Therapy<br>* superficial heating for 20 minutes<br>|
| Active Comparator: Active Comparator Group<br> | Procedure: Mckenzie Extension Protocol<br>* Mckenzie Extension Exercise Protocol will be performed by participants in prone position<br>Device: inferential therapy<br>* 4 pole inferential therapy in combination with superficial heating for 20 minutes<br>Device: Heat Therapy<br>* superficial heating for 20 minutes<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Back Pain | Pain will be measured via Visual Analogue Scale. A higher score signifies poor outcome. | 2 weeks | 
| Lumbar Range of Motion | Disability will be measured via inclinometer. A higher score signifies good outcome. | 2 weeks | 
| Postural Stability | Postural Stability will be measured via Biodex Balance System. A higher score signifies poor outcome. | 2 weeks | 
| Lumbar Disability | Disability will be measured via Oswestry Disability Index. | 2 weeks |