About
Scope & Aims
Editorial office
Editorial board
Reviewers
Ethical standards and procedures
Abstracting and indexing
Contact
Articles & Issues
Current issue
Articles in press
Archive
For Authors
General rules
Guide for authors
Templates
Publication charge
For Reviewers
Guide for reviewers
Our reviewers
ORIGINAL PAPER
Effect of Maitland mobilization on lumbar proprioception, pain, and disability in patients with chronic nonspecific low back pain
1
Basic Science Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
2
Department of Neurosurgery, Faculty of Medicine, Cairo University, Giza, Egypt
3
Department of Medical Divisions, National Research Center, Giza, Egypt
Submission date: 2022-06-29
Acceptance date: 2022-09-06
Publication date: 2023-03-27
Physiother Quart. 2023;31(4):87-92
KEYWORDS
TOPICS
ABSTRACT
Introduction:
To investigate the short-term effect of Maitland mobilization on lumbar proprioception, pain intensity, and functional disability in patients with chronic nonspecific low back pain (CNSLBP).
Methods:
Fifty-four subjects aged 18–30 years old with CNSLBP were randomly assigned into two groups. The experimental group received a selected exercise program (stretching, strengthening, and lumbar stabilization exercises) and Maitland posterior-anterior vertebral mobilization three sessions /week, whereas the control group received exercises only. Lumbar repositioning error (LRE), pain intensity, and function disability were measured using an isokinetic dynamometer, visual analog scale (VAS), and the Arabic version of the Oswestry Disability Index (ODI), respectively. Measurements were taken at baseline and four weeks after intervention.
Results:
Within-group analysis showed a significant decrease in LRE, VAS, and ODI after treatment (p < 0.001). Between-group analysis revealed a significant difference between groups post-intervention favoring the Maitland mobilization group (p < 0.001) where the mean differences at 95% confidence interval were (–2.10, –1.36) for LRE, (–34.53, –25.61) for VAS and (–9, –7.07) for ODI.
Conclusions:
Maitland lumbar mobilization is effective in improving lumbar proprioception, pain intensity, and functional disability in patients with CNSLBP.
To investigate the short-term effect of Maitland mobilization on lumbar proprioception, pain intensity, and functional disability in patients with chronic nonspecific low back pain (CNSLBP).
Methods:
Fifty-four subjects aged 18–30 years old with CNSLBP were randomly assigned into two groups. The experimental group received a selected exercise program (stretching, strengthening, and lumbar stabilization exercises) and Maitland posterior-anterior vertebral mobilization three sessions /week, whereas the control group received exercises only. Lumbar repositioning error (LRE), pain intensity, and function disability were measured using an isokinetic dynamometer, visual analog scale (VAS), and the Arabic version of the Oswestry Disability Index (ODI), respectively. Measurements were taken at baseline and four weeks after intervention.
Results:
Within-group analysis showed a significant decrease in LRE, VAS, and ODI after treatment (p < 0.001). Between-group analysis revealed a significant difference between groups post-intervention favoring the Maitland mobilization group (p < 0.001) where the mean differences at 95% confidence interval were (–2.10, –1.36) for LRE, (–34.53, –25.61) for VAS and (–9, –7.07) for ODI.
Conclusions:
Maitland lumbar mobilization is effective in improving lumbar proprioception, pain intensity, and functional disability in patients with CNSLBP.
REFERENCES (40)
1.
Becker A, Held H, Redaelli M, Strauch K, Chenot JF, Leonhardt C, et al. Low back pain in primary care: costs of care and prediction of future health care utilization. Spine. 2010;35(18):1714–1720; doi: 10.1097/brs.0b013e3181cd656f.
2.
Krismer M, van Tulder M., et al. Low back pain (non-specific). Best Pract Res Clin Rheumatol. 2007;21(1):77–91; doi: 10.1016/j.berh.2006.08.004.
3.
O’Sullivan P. Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism. Man Ther. 2005;10(4):242–255; doi: 10.1016/j.math.2005.07.001.
4.
Bardin LD, King P, Maher CG. Diagnostic triage for low back pain: a practical approach for primary care. Med J Aust. 2017;206(6):268–273; doi: 10.5694/mja16.00828.
5.
Brumagne S, Dolan P, Pickar JG. What is the relation between proprioception and low back pain? In: Hodges PW, Cholewcki J, van Dieen JH (eds.) Spinal Control:The Rehabilitation of Back Pain. Churchill Livingstone–Edinburg–London: Elsevier; 2013:219–230; doi: 10.1016/B978-0-7020-4356-7.00019-7.
6.
Riemann BL, Lephart SM. The sensorimotor system, part II: the role of proprioception in motor control and functional joint stability. J Athl Train. 2002;37(1):80–84.
7.
Gilman S. Joint position sense and vibration sense, anatomical organisation and assessment. J Neurol Neurosurg Psychiatry. 2002;73(5):473–477; doi: 10.1136/jnnp. 73.5.473.
8.
Laird RA, Gilbert J, Kent P, Keating JL. Comparing lumbopelvic kinematics in people with and without back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2014;15:229; doi: 10.1186/1471-2474-15-229.
9.
Hidalgo B, Gobert F, Bragard D, Detrembleur C. Effects of proprioceptive disruption on lumbar spine repositioning error in a trunk forward bending task. J Back Musculoskelet Rehabil. 2013;26(4):381–387; doi: 10.3233/BMR-130396.
10.
Georgy EE. Lumbar repositioning accuracy as a measure of proprioception in patients with back dysfunction and healthy controls. Asian Spine J. 2011;5(4):201–207; doi: 10.4184/asj.2011.5.4.201.
11.
van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Ostelo RW, Koes BW, et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine J. 2011;20(1):19–39; doi: 10.1007/s00586-010-1518-3.
12.
Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Wiemer M, et al. Nonpharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guideline. Ann Intern Med. 2017;166(7):493–505; doi: 10.7326/M16-2459.
13.
Samir SM, Zaky LA, Soliman MO. Mulligan versus Maitland mobilizations in patients with chronic low back dysfunction. Int J Pharm Tech Res. 2016;9:92–99.
14.
Tuttle N. Do changes within a manual therapy treatment session predict between-session changes for patients with cervical spine pain? Aust J Physther. 2005;51(1): 43–48; doi: 10.1016/s0004-9514(05)70052-0.
15.
Maitland GD. Maitland’s Vertebral Manipulation. 17th ed. Hengeveld E, Banks E (eds.) Edinburg–New York: Churchill Livingstone; 2013;280–300.
16.
Abe KY, Tozim BM, Navega MT. Acute effects of Maitland’s central posteroanterior mobilization on youth with low back pain. Man Ther, Posturology Rehabil J. 2015;13(234):1–5; doi: 10.17784/mtprehabJournal.2015.13.234.
17.
Shum, GL, Tsung BY, Lee RY. The immediate effect of posteroanterior mobilization on reducing back pain and the stiffness of the lumbar spine. Arch Phys Med Rehabil. 2013;94(4):673–679; doi: 10.1016/j.apmr.2012.11.020.
18.
Snodgrass SJ, Rivett DA, Robertson VJ. Manual forces applied during posterior-to-anterior spinal mobilization: a review of the evidence. J Manipulative Physiol Ther. 2006;29(4):316–329; doi: 10.1016/j.jmpt.2006.03.006.
19.
Hussien MH, Abdel-Raoof NA, Kattabei OM, Ahmed HH. Effect of Mulligan concept lumbar SNAG on chronic nonspecific low back pain. J Chiropr Med. 2017;16(2):94–102; doi: 10.1016/j.jcm.2017.01.003.
20.
Shenouda MMSS, Draz AH, Shendy WS. Relationship between proprioception and trunk muscles strength at different trunk velocities in patient with lumbar disc prolapse. Bull Fac Ph Th Cairo Univ. 2011;16(1):135–141.
21.
Wilson SE, Granata KP. Reposition sense of lumbar curvature with flexed and asymmetric lifting postures. Spine. 2003;28(5):513–518; doi: 10.1097/01.BRS.0000048674. 75474.C4.
22.
O’Sullivan PB, Burnett A, Floyd AN, Gadsdon K, Logiudice J, Miller D, et al. Lumbar repositioning deficit in a specific low back pain population. Spine. 2003;28(10):1074–1079; doi: 10.1097/01.BRS.0000061990.56113.6F.
23.
Kersten P, Küçükdeveci AA, Tennant A. The use of the Visual Analogue Scale (VAS) in rehabilitation outcomes. J Rehabil Med. 2012;44(7):609–610; doi: 10.2340/16501977-0999.
24.
Guermazi M, Mezghani M, Ghroubi S, Elleuch M, Ould Sidi Med A, Poiraudeau S, et al. The Oswestry index for low back pain translated into Arabic and validated in an Arab population [in French]. Ann Readapt Med Phys. 2005;48(1):1–10; doi: 10.1016/j.annrmp.2004.06.055.
25.
Abbot JH, Flynn TW, Fritz JM, Hing WA, Reid D, Whiteman JM. Manual physical assessment of spinal segmental motion: intent and validity. Man Ther. 2009;14(1):36–44; doi: 10.1016/j.math.2007.09.011.
26.
Chopade P. Comparison of Maitland’s mobilization and Mckenzie therapy in patients with non-specific low back pain. Int J Biol Res. 2018;9:6270–6277.
27.
Hanrahan S, Van Lunen BL, Tamburello M, Walker ML. The short-term effects of joint mobilizations on acute mechanical low back dysfunction in collegiate athletes. J Athl Train. 2005;40(2):88–93.
28.
Kachanathu SJ, Alenazi AM, Seif HE, Hafez AR, Alroumim MA. Comparison between Kinesio taping and a traditional physical therapy program in treatment of nonspecific low back pain. J Phys Ther Sci. 2014;26(8):1185–1188; doi: 10.1589/jpts.26.1185.
29.
Kisner C, Colby LA. Therapeutic Exercise: Foundations and Techniques. Philadelphia: Davis; 2012:190–210.
30.
Alrwaily M, Schneider M, Sowa G, Timko M, Whitney SL, Delitto A. Stabilization exercises combined with neuromuscular electrical stimulation for patients with chronić low back pain: a randomized controlled trial. Braz J Phys Ther. 2019;23(6):506–515; doi: 10.1016/j.bjpt.2018.10.003.
31.
Ianuzzi A, Pickar JG, Khalsa PS. Relationships between joint motion and facet joint capsule strain during cat and human lumbar spinal motions. J Manipulative Physiol Ther. 2011;34(7):420–431; doi: 10.1016/j.jmpt.2011.05.005.
32.
Gong W. The influence of lumbar joint mobilization on joint position sense in normal adults. J Phys Ther Sci. 2014;26(12):1985–7; doi: 10.1589/jpts.26.1985.33.
33.
Sharma A, Alahmari K, Ahmed I. Efficacy of manual therapy versus conventional physical therapy in chronic low back pain due to lumbar spondylosis. A pilot study. Med. Sci (Basel). 2015;3(3):55–63; doi: 10.3390/medsci3030055.
34.
Krekoukias G, Petty NJ, Cheek L. Comparison of Surface electromyographic activity of erector spinae before and after the application of central posteroanterior mobilisation on the lumbar spine. J Electromyogr Kinesiol. 2009;19(1):39–45; doi: 10.1016/j.jelekin.2007.06.020.
35.
Patel KM. Effect of Maitland mobilization versus mulligan (SNAGs) mobilization on head repositioning accuracy (HRA), pain and functional disability in patients with chronic neck pain. 4th International Conference on Orthopedics & Rheumatology. October 26–28, 2015 Baltimore, Maryland. Orthop Muscular Syst. 2015;4:4.
36.
Colloca CJ, Keller TS. Electromyographic reflex responses to mechanical forces, manually assisted spinal manipulative therapy. Spine. 2001;26(10):1117–1124; doi: 10.1097/00007632-200105150-00005.
37.
Telci AE, Yagci N, Can T, Cavlak U. The impact of chronić low back pain on physical performance, fear avoidance beliefs, and depressive symptoms: a comparative study on Turkish elderly population. Pak J Med Sci. 2013;29(2): 560–564; doi: 10.12669/pjms.292.3196.
38.
Baig AAM, Ahmed SI, Ali SS, Rahmani A, Siddiqui F. Role of posterior-anterior vertebral mobilization versus thermotherapy in non specific lower back pain. Pak J Med. Sci. 2018;34(2):435–439; doi: 10.12669/pjms.342.12402.
39.
Sakulsriprasert P, Vachalathiti R, Vongsirinavarat M, Pichaisak W, Sophonratanapokin B. Effects of physical therapy treatments with and without spinal mobilization in individuals with acute nonspecific low back pain: a randomized trial. Indian J Physiother Occup Ther. 2010;4:107–111.
40.
Mackawan S, Eungpinichpong W, Pantumethakul R, Chatchawan U, Hunsawong T, Arayawichanon P. Effects of traditional Thai massage versus joint mobilization on substance P and pain perception in patients with non-specific low back pain. J Bodyw Mov Ther. 2007;11(1):9–16; doi: 10.1016/j.jbmt.2005.11.001.
| eISSN: | 2544-4395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
