Efficacy of Manual Therapy versus Conventional Physical Therapy in Chronic Low Back Pain Due to Lumbar Spondylosis. A Pilot Study

Arti Sharma, Khalid Alahmari, Irshad Ahmed, Arti Sharma, Khalid Alahmari, Irshad Ahmed

Abstract

Objectives: The objective of this work was to compare the efficacy of Maitland mobilization and conventional physical therapy on pain response, range of motion (ROM) and functional ability in patients with chronic low back pain due to lumbar spondylosis.

Methods: A total sample of 30 subjects (40-70 years of age) with complaints of slow insidious onset of low back pain (LBP), with or without radiation not less than three months duration and decrease ROM were randomly assigned to: group-I, Maitland mobilization and lumbar stabilization exercises; group-II conventional physical therapy (traction, strengthening, stretching exercises.) and outcomes were assessed for dependent variables.

Results: There is statically a significant difference between pre and post measurement readings with time (p = 0.00) and between groups (p < 0.05) with respect to pain and function, but, with respect to ROM readings, showed statistical significance with time (p = 0.00) and no significance between groups (p > 0.05), indicating manual therapy group-I is improving faster and better than conventional physical therapy group-II.

Conclusion: Our results showed that manual therapy interventions are more effective in managing low back pain, and function and range of motion of the lumbar spine than conventional physical therapy treatment.

Keywords: exercise; low back pain; maitland; mobilization; traction.

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Middleton K., Fish D.E. Lumbar spondylosis: clinical presentation and treatment approaches. Curr. Rev. Musculoskelet. Med. 2009;2:94–104. doi: 10.1007/s12178-009-9051-x.
    1. Miller J.K. The Meckenzie Approach. Clin. Orthop. 1992;279:8–20.
    1. Albright J., Allman R., Bonfiglio R.P., Conill A., Dobkin B., Guccione A.A., Hasson S.M., Russo R., Shekelle P., Susman J.L., et al. Philadelphia panel evidence-based clinical practice guidelines on selected rehabilitation interventions for neck pain. Phys. Ther. 2001;81:1701–1717.
    1. Rothschild B. Lumbar Spondylosis. [(accessed on 10 June 2015)]. Available online: .
    1. Di Fabio R.P. Clinical Assessment of Manipulation and Mobilization of the Lumbar Spine: A Critical Review of the Literature. Phys. Ther. 1986;66:51–54.
    1. Koumantakis G.A., Watson P.J., Oldham J.A. Trunk Muscle Stabilization Training Plus General Exercise versus General Exercise Only: Randomized Controlled Trial of Patients With Recurrent Low Back pain. Phys. Ther. 2005;85:209–225.
    1. Bronfort G., Haas M., Evans R., Leininger B., Triano J. Effectiveness of manual therapies: The UK evidence report. Chiropr. Osteopat. 2010;18:3. doi: 10.1186/1746-1340-18-3.
    1. Maitland G.D., Hengeveld E., Banks K., English K. Maitland’s Vertebral Manipulation. 6th ed. Butterworth-Heinemann; Oxford, UK: 2001.
    1. Gregory P. Mobilization of the Spine. 4th ed. Grieve Churchill Livingstone; Edinburgh, UK: 1984.
    1. Aure O.F., Nilsen J.H., Vasseljen O. Manual Therapy and Exercise Therapy in Patients with Chronic Low Back Pain. Spine. 2003;28:525–531. doi: 10.1097/01.BRS.0000049921.04200.A6.
    1. Rasmussen-Barr E., Nilsson-Wikmar L., Arvidsson I. Stabilizing training compared with manual treatment in sub-acute and chronic low-back pain. Man. Ther. 2003;8:233–241. doi: 10.1016/S1356-689X(03)00053-5.
    1. Triano J.J. Biomechanics of spinal manipulative therapy. Spine J. 2001;1:121–130. doi: 10.1016/S1529-9430(01)00007-9.
    1. Gracey J., McDonough S., Baxter G. Physical Therapy management of low back pain. Spine. 2002;27:406–411. doi: 10.1097/00007632-200202150-00017.
    1. Tuttle N. Do changes within a manual therapy treatment session predict between-session changes for patients with cervical spine pain? Aust. J. Phys. Ther. 2005;51:43–48. doi: 10.1016/S0004-9514(05)70052-0.
    1. Coulehan J.L. Adjustment, the hands, and healing. Culture Med. Psychiatry. 1985;9:353–382.
    1. Melzac R., Wall P.D. Pain mechanisms. A new theory. Science. 1965;150:971–979. doi: 10.1126/science.150.3699.971.
    1. Grieve G. Mobilization of the Spine. 5th ed. Churchill Livingstone; Edinburgh, UK: 1991.

Source: PubMed

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