Mulligan SNAG Technique in Individuals With Lumbar Intervertebral Disc Protrusion

April 3, 2025 updated by: Ugur Cavlak, Biruni University

Effect of the Mulligan SNAG Technique on Structure of Intervertebral Disc and Physical Functioning in Individuals With Lumbar Intervertebral Disc Protrusion: A Randomized Controlled Study

This study aimed to examine the effects of the Mulligan SNAG mobilization technique, applied in addition to conventional physiotherapy on the structure of the intervertebral disc and physical functioning in patients diagnosed with low back pain due to lumbar intervertebral disc protrusion. 38 volunteer patients will participate in the study. The participants will be randomized as an interventional and control gropus.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

Participants will be treated 3 days a week for 4 weeks. The session duration will be 40-45 minutes. Visual analog scale-VAS, oswestry disability index, magnetic imaging-MRI assessment, functıonal independence scale-FIM, Tampa kinesiophobia scale, one leg stand test, sit-stand test, 10-meter walking test, cadence , Nottingham health profile will be used to assses the participants in the two groups. All participants will be evaluated in the 5th week of the study. The program includes physical therapy session (Hot packed, trans cuteneal electric stimulation, therapeutic ultrasound, and therapautic exercises) and the Mulligan SNAG mobilization technique.

Study Type

Interventional

Enrollment (Estimated)

38

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
    • Zeytinburnu
      • İ̇stanbul, Zeytinburnu, Turkey, 34010
        • Faculty of Health Sciences in Biruni University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Being between the ages of 20-60
  2. Those diagnosed with lumbar intervertebral disc heniation (protrusion on L1-L2, L2-L3, L3-L4, L4-L5, L5-S1) at a single level
  3. Those who voluntarily agreed to participate in the study

Exclusion Criteria:

  • Individuals diagnosed with Lumbar Bulging, Extruded, Sequestered discs
  • Individuals who have undergone lumbar region spinal surgery
  • Individuals with spinal deformity (scoliosis, spondylolisthesis, Ankylosing Spondylitis)
  • Individuals with lumbar stenosis
  • Pregnant women
  • Individuals receiving treatment for malignancy (primary or metastatic tumoral conditions in the lumbar region)
  • Individuals diagnosed with advanced osteoporosis
  • Individuals diagnosed with discitis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group 1
SNAG
Other: Mulligan SNAG mobilization tecnique
Mulligan SNAG mobilization tecnique
Other: Conventional Physiotherapy
Conventional Physiotherapy
Active Comparator: Group 2
Physiotherapy
Other: Conventional Physiotherapy
Conventional Physiotherapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Magnetic Resonance Imaging
Time Frame: baseline and iafter the intervention (in the 5th week)
to measure protrusion (bigger amount means worse outcome)
baseline and iafter the intervention (in the 5th week)
Visual Analog Scale-VAS
Time Frame: baseline and immediately after the intervention (in the 5th week)
to measure pain intensity (min. score is 0 and max. score is 10- higher score means worse outcome)
baseline and immediately after the intervention (in the 5th week)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Oswestry Disability Index-ODI
Time Frame: baseline and immediately after the intervention (in the 5th week)
to describe disabilty level resulting from pain (min. score is 0 and max. score is 50- higher score means worse outcome)
baseline and immediately after the intervention (in the 5th week)
Functional Independence Measure- FIM
Time Frame: baseline and immediately after the intervention (in the 5th week)
to measure independency in daily living activities (min. score is 18 and max score is 156- higger score means better independency in daily living activities)
baseline and immediately after the intervention (in the 5th week)
Tampa Kinesiophobia Scale- TKS
Time Frame: baseline and immediately after the intervention (in the 5th week)
to measure anxiety-avoidance state (min. score is 17 and max. score is 68- higher score means worse outcome)
baseline and immediately after the intervention (in the 5th week)
One Leg stand Test- OLST
Time Frame: before and after the intervention (in the 5th week)
to measure static balance ability (min. score 0 and max. score is 60- Higher score means better balance)
before and after the intervention (in the 5th week)
Sit-Stand Test-SST
Time Frame: before and after the intervention (in the 5th week)
to measure lower extremity performance (min. score is 0 and max. score is 30- higher score means better outcome)
before and after the intervention (in the 5th week)
10-m Walking test and cadance measurement
Time Frame: before and after the intervention (in the 5th week)
to measure walking speed (in second- higher score means worse outcome) and cadance (number of steps during the test- higher score means better outcome)
before and after the intervention (in the 5th week)
Nottingham Health profile-NHP
Time Frame: before and after the intervention (in the 5th week)
to describe level of quality of life (min. score is 38 and max. score is 3800 - higher score means poor health)
before and after the intervention (in the 5th week)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Biruni University

Investigators

  • Principal Investigator: UGUR CAVLAK, Prof., Biruni University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 16, 2025

Primary Completion (Estimated)

December 30, 2025

Study Completion (Estimated)

January 15, 2026

Study Registration Dates

First Submitted

July 16, 2024

First Submitted That Met QC Criteria

July 24, 2024

First Posted (Actual)

July 25, 2024

Study Record Updates

Last Update Posted (Actual)

April 6, 2025

Last Update Submitted That Met QC Criteria

April 3, 2025

Last Verified

April 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • BiruniUniversity34

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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