Immediate Effect of Two Selected Mulligan Techniques in Nonspecific Low Back Pain

Study Overview
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Brief Summary
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To compare between immediate effect of SNAG and mulligan lion position in range of motion (ROM) , pain, functional ability and kinesiophobia on patients with nonspecific low back pain.

Detailed Description
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Low back pain (LBP) is a global health problem.Orthopedic Manual therapy (OMT) is most commonly recommended form of treatment of LBP and it is also frequently used in clinical practice in various countries. Mulligan introduced a new technique in manual therapy. Mulligan has a great role in the treatment of LBP.General techniques of mulligan are MWM, SNAGs and natural apophyseal glides (NAGs). Lumber SNAG have immediate and short term on pain and function in treatment of patients with NSLBP.Mulligan has special techniques, one of them is modified lumbar SNAG (lion position) .It has short term effect in reducing pain and activity limitation. Up to investigated knowledge, No previous studies comparing immediate effect of two techniques in range of motion (ROM), pain, functional ability and kinesiophobia

Official Title
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Immediate Effect of Two Selected Mulligan Techniques on Lumbar Sagittal Mobility in Nonspecific Low Back Pain

Conditions
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Back Pain

Intervention / Treatment
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* Procedure: mulligan SNAG and mulligan lion position


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 3 to 7 on VAS. Back Pain duration of 6 week or more . 20-40 years old . Patients of both sexes will be concluded . body mass index (18.5-29.9 KG/M2). Exclusion Criteria: fracture, osteoporosis, myelopathy, multiple adjacent radiculopathies, cauda equina syndrome, vertebral bone disease and bony joint instability . Infective conditions of spine, autoimmune disorders, Pacemakers, malignancy . History of surgery or injection at lumbar spine 1 year ago .

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 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
Interventional Model Description: mulligan SNAG and mulligan lion position
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: mulligan SNAG<br>Patients in this group will receive mulligan SNAG from sitting position and McGill stabilization exercises.The glide will be performed six repetitions for three sets for one session and McGill stabilization exercises as a home program: 7 days a week and 10 repetitions of each exercise for 2times per day and a rest interval of 2 minutes between exercises | Procedure: mulligan SNAG and mulligan lion position<br>* manual therapy techniques for lumbar spine<br>* Other names: moblization with movement;|
| Experimental: mulligan lion position<br>Patients in this group will receive mulligan modified lumbar SNAG lion position and McGill stabilization exercises.Modified lumbar SNAGs (lion position) will be applied in a quadruped position (lion position)six repetitions for three sets for one session . McGill stabilization exercises as a home program: 7 days a week and 10 repetitions of each exercise for 2times per day and a rest interval of 2 minutes between exercises The therapist stands to one side of the patient and applies (SNAG) centrally to the spinous process of the involved segment. The medial border of the hand is hooked under the chosen segment while the other arm encircles the trunk to stabilize the upper body. The therapist maintains the glide while the patient sits back towards their heels (for flexion) . | Procedure: mulligan SNAG and mulligan lion position<br>* manual therapy techniques for lumbar spine<br>* Other names: moblization with movement;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ROM | ROM by bubble inclinometer | up to 2 hours after technique | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| degree of Pain | Pain will be assessed by VAS. | one week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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mulligan, lumbar, sagittal, mobility, Back, pain