The Effect of Mulligan Mobilization Technique on Balance, Pain and Functionality in Patients With Chronic Low Back Pain

This study was aimed to investigate the effectiveness of mulligan mobilization technique on balance, pain and functionality in patients with chronic low back pain and to compare it with exercise.37 patients aged between 18-65 who applied to Fındıkzade Medipol Hospital were included in the study. The individuals participating in the study were divided into two groups, 18 control and 19 mulligan groups, according to the randomization table. The intervention was performed 3 times a week for 4 weeks. Conventional physiotherapy and exercise program accompanied by a physiotherapist were applied to the control group, and conventional physiotherapy and mulligan mobilization technique were applied to the mulligan group. Conventional physiotherapy methods included ultrasound (US), Transcutaneous Electrical Nerve Stimulation (TENS), and hotpack. The patients were evaluated with TecnoBody Static Balance Device, algometer, electrogoniometer, visual analog scale, Oswestry Low Back Pain Disability Questionnaire before and after the treatment.

Study Overview

• Status: Completed
• Conditions: Chronic Low-back Pain; Lumbal Disc Herniation; Imbalance
• Intervention / Treatment: Other: Mulligan Technique; Other: Exercise Therapy

• Study Type: Interventional
• Enrollment (Actual): 37
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Fındıkzade
    • Istanbul, Fındıkzade, Turkey, 34093
      • Fındıkzade Medipol Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Experiencing non-specific chronic low back pain for more than 3 months
• The diagnosis has been confirmed by the Health Board Report
• Be over 18 years old
• Be younger than 65 years old
• Pain of at least 2 severity according to VAS
• Voluntarily agree to participate in the study

Exclusion Criteria:

• Previous lumbar trauma or operation
• Long-term use of corticosteroids
• Cancer
• Pregnancy
• Osteoporosis
• Systemic Diseases
• Spinal Deformities
• Lumbal Stenosis
• Ankylozone Spondylitis
• Spondylolisthesis
• Spinal Deformities
• Lumbal Stenosis

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Control Group	Other: Exercise Therapy; Exercise is recommended by physical therapists for most chronic low back pain patients.
EXPERIMENTAL: Mulligan Group	Other: Mulligan Technique; Mulligan suggested that injuries or sprains can cause a minor positional error in a joint, thereby causing limitations in physiological movement. Unique to this concept is mobilization of the spine while weight bearing and directing the mobilization parallel to the spinal facet planes. Although it includes various mobilization techniques, one of the most important techniques, motion co-mobilization, is the SNAG's technique, which includes the application of accessory passive gliding to the lumbar vertebra while the patient performs active movement simultaneously.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
TecnoBody Static Balance Device Measurements	TecnoBody Stability Easy is a stabilometric system consisting of three highly sensitive sensors. The system is based on continuous observation of the foot pressure center (COP). By recording the postural oscillations of the body as a function of time, detailed information about the postural system is obtained	5 Minutes
Pressure Pain-Threshold Measurements with Algometer	It is a device used to evaluate the sensitivity to pain and to determine the perception of pressure. The pressure algometer has proven useful in evaluating fibrositis and hypersensitive spots, trigger points, arthritis activation, and visceral pain-pressure sensitivity.	5 Minutes
Electrogoniometer	It is an evaluation tool used to record the objective measurement of joint range of motion.	5 Minutes

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analog Scale	Visual Analog Scale (VAS) is used to convert some values that cannot be measured numerically into digital. Two end definitions of the parameter to be evaluated are written on both ends of a 100 mm line and the patient is asked to indicate where his / her condition is appropriate by drawing a line or by placing a dot or marking.	1 Minutes
Oswestry Disability Index	The Oswestry Disability Index is a commonly used outcome measure to detect perceived disability in patients with low back pain. It consists of 10 questions, each of which is scored between 0 and 5, assessing the degree of pain, personal care, lifting, walking, sitting, standing, sleeping, social life, traveling, and change in pain. The minimum score obtained from the scale is 0, and the maximum score is 50. 0-4 points as no disability, 5-14 points as mild, 15-24 points as moderate, 25-34 points as severe and 35-50 points as complete functional disability.	10 Minutes

Collaborators and Investigators

• Sponsor: Medipol University
• Investigators: Principal Investigator: Kübra Bali, Licenced, Medipol University

Study record dates

Study Major Dates

• Study Start (ACTUAL): July 10, 2021
• Primary Completion (ACTUAL): February 1, 2022
• Study Completion (ACTUAL): February 15, 2022

Study Registration Dates

• First Submitted: April 4, 2022
• First Submitted That Met QC Criteria: April 12, 2022
• First Posted (ACTUAL): April 19, 2022

Study Record Updates

• Last Update Posted (ACTUAL): April 19, 2022
• Last Update Submitted That Met QC Criteria: April 12, 2022
• Last Verified: April 1, 2022

More Information

Terms related to this study

• Keywords: Exercise; Balance; Chronic Low Back Pain; Manual Therapy; Mulligan Mobilization; Lumbal Disc Herniation
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Pathological Conditions, Anatomical; Spinal Diseases; Bone Diseases; Back Pain; Low Back Pain; Hernia; Intervertebral Disc Displacement
• Other Study ID Numbers: E-10840098-772.02-2868

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No