Effect of Mulligan Versus Maitland Mobilization on Lumbar Proprioception in Patients With Chronic Nonspecific Low Back Pain

NCT ID: NCT06941220

Last Updated: 2025-04-23

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 90 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-04-15
• Study Completion Date: 2025-08-01

Brief Summary

this study will be conducted to compare between the effect of mulligan mobilization versus Maitland mobilization on pain ,function and lumbar proprioception in patients with chronic nonspecific low pain

Detailed Description

Low back pain (LBP) is considered as one of the most widespread musculoskeletal disorders, impacting over 80% of the world's population, resulting in work absence, medical consultation, a decline in quality of life, and financial burden. Lumbar repositioning error was high around 30° of trunk flexion in individuals with CLB. When lumbar proprioceptive deficiencies arise, the activation pattern of back muscles is disturbed, the mechanics of the spinal unit differs from that of a healthy spine, and the recurrence rate of LBP increases . CLBP is managed using various intervention modalities, including drug therapy and physical therapy approaches . Physical therapy modalities, such as manual therapy, therapeutic exercises, and biopsychosocial techniques, are used for treating LBP. Manual therapy is a common and suggested modality for treating CLBP that has strong evidence. It is employed in physical therapy practice, including Maitland mobilization and Mulligan mobilization. Mulligan mobilization as well as Maitland mobilization has significant effect on pain ,function disability and lumbar repositioning error. But there is gap about which is more beneficial. So we conduct this study to determine which technique is more beneficial for patients

Conditions

Low Back Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

mulligan group

thirty patients will receive mulligan sustained natural apophyseal glide (SNAG) for each level was 3 sets of 6 repetitions 3 times per week for 1 month plus traditional therapy

Group Type: EXPERIMENTAL

mulligan group

Intervention Type: OTHER

SNAG technique was applied from a sitting position on the edge of the table while both feet were on a foot rest. A specialized Mulligan belt was used around the patient's waist and therapist's hips. The mobilizing force was applied parallel to the facet joint plane (cephalic direction) and over the spinous processes of the respective symptomatic spinal levels. The patients were asked to lean forward as much as possible during application of the mobilizing force and then return to the starting position while the therapist maintained his mobilizing force until the end. plus traditional therapy

traditional therapy

Intervention Type: OTHER

the patients will receive traditional therapy in the form of passive stretching, strengthening, and lumbar stabilization exercises

Maitland mobilization

thirty patients will receive Maitland 3 times per week for 1 month plus traditional therapy

Group Type: EXPERIMENTAL

Maitland mobilization

Intervention Type: OTHER

The subjects were placed in the prone position on a plinth with their hands beside them, and the therapist stood on the subject's side, the ulnar surface of the hand (between pisiform and hamate) was placed over the hypomobile spinous process. The second hand was placed on top of the first to enhance its force. With the therapist's elbows slightly bent and shoulders exactly above the spinous process, an oscillatory movement of the vertebra was executed by applying a posterior-anterior force to the hypomobile or painful spinous process.

Grade III mobilization was applied four times, each with 60 s of oscillation and 20 s of rest in between them (2 or 3 oscillations per second) plus traditional therapy

traditional therapy

Intervention Type: OTHER

the patients will receive traditional therapy in the form of passive stretching, strengthening, and lumbar stabilization exercises

traditional therapy

thirty patients will receive traditional therapy three times a week for four weeks

Group Type: ACTIVE_COMPARATOR

traditional therapy

Intervention Type: OTHER

the patients will receive traditional therapy in the form of passive stretching, strengthening, and lumbar stabilization exercises

Interventions

mulligan group

SNAG technique was applied from a sitting position on the edge of the table while both feet were on a foot rest. A specialized Mulligan belt was used around the patient's waist and therapist's hips. The mobilizing force was applied parallel to the facet joint plane (cephalic direction) and over the spinous processes of the respective symptomatic spinal levels. The patients were asked to lean forward as much as possible during application of the mobilizing force and then return to the starting position while the therapist maintained his mobilizing force until the end. plus traditional therapy

Intervention Type: OTHER

Maitland mobilization

The subjects were placed in the prone position on a plinth with their hands beside them, and the therapist stood on the subject's side, the ulnar surface of the hand (between pisiform and hamate) was placed over the hypomobile spinous process. The second hand was placed on top of the first to enhance its force. With the therapist's elbows slightly bent and shoulders exactly above the spinous process, an oscillatory movement of the vertebra was executed by applying a posterior-anterior force to the hypomobile or painful spinous process.

Grade III mobilization was applied four times, each with 60 s of oscillation and 20 s of rest in between them (2 or 3 oscillations per second) plus traditional therapy

Intervention Type: OTHER

traditional therapy

the patients will receive traditional therapy in the form of passive stretching, strengthening, and lumbar stabilization exercises

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• They had interrupted or continuous LBP symptoms for more than 3 months
• both gender

Exclusion Criteria

• specific LBP
• those who were pregnant
• those with neurological problems

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Al Shaymaa Shaaban Abd El Azeim

principle investigator : alshaymaa shaaban abd el azeim

Responsibility Role: PRINCIPAL_INVESTIGATOR

Central Contacts

alshaymaa abd elazeim, phd

Role: CONTACT

alshaymaa.shaaban@pt.cu.edu.eg

01033771553

adel ibrahim, phd

Role: CONTACT

Adelmhmd4444@gmail.com

01126937665

Other Identifiers

P.T.REC/012/005680

Identifier Type: -

Identifier Source: org_study_id