The efficacy of a ‘novel mobilisation technique’ on thoracic, lumbar, hip and knee range of motion

Abstract

INTRODUCTION TO THESIS

Low back pain (LBP) is one of the most common complaints addressed by manual therapists (Slater, Davies, Parsons, Quitner, & Schug, 2012), and there is an extensive literature regarding aetiology, classification, methods of diagnosis and effective treatments for LBP. Low back pain has a substantial financial cost to the healthcare system and employers due to decreased productivity and lost days from work (Wynne-Jones et al., 2014).

A wide range of different forms of manual and manipulative therapy have been investigated for the treatment of LBP (Hidalgo, Detrembleur, Hall, Mahaudens, & Nielens, 2014; Tsertsvadze et al., 2014) One form of therapy popular amongst manual therapy practitioners is the ‘Mulligan concept’ (Hing, Bigelow, & Bremner, 2008).BACKGROUND: Low back pain is a common problem affecting most people at some stage in their lives. Manual therapy is commonly used as a form of treatment in the presence of lower back pain.

ABSTRACT

AIM:The aim of the study was to investigate the concepts of regional interdependence with Mulligan’s mobilisation with movement and the effect of a novel mobilisation technique (Mulligan’s traction SLR combined with a post-isometric relaxation).

STUDY DESIGN The present study was a controlled pre-post experimental research design.

METHOD: Twelve, healthy and physically active male participants (mean age 28.1 ± 3.5 years), with perceived ‘tight hamstrings’ were recruited for the study. Participants were randomised to receive the novel mobilisation technique to the left (n=6) or right (n=6) leg, using the contralateral limb as the control. Outcome measures included; SLR, KE, modified Schober’s (Tsp, Lsp) and sit and reach tests, which were taken before, immediately and 1 hour post intervention.

RESULTS The main statistically significant and clinically meaningful result included immediate changes in the modified Schober’s Tsp (mean difference = -0.40 ± SD 0.48, 95% CI -0.70 to -0.10, t = -2.9, p = 0.014, d = 0.435) and changes in the sit and reach test immediately post (mean difference = -2.20cm ± 1.56, 95% CI -3.30 to -1.20cm, t = -4.869, p<0.001, d= 0.325, “small”) and at 1-hour post (mean difference = -2.62 ± 2.89, 95% CI -4.5 to -0.78cm, t = -3.1, p = 0.009, d = 0.39 “small”) . There were no significant changes in the SLR, KE active or passive and modified Schober’s Lsp tests, immediately or 1-hour post intervention.

CONCLUSION The novel mobilisation technique applied to the hip demonstrated statistically significant changes in the modified Schober’s Tsp and sit and reach tests. The main limitations to the present study included a potential ‘ceiling’ effect with the baseline SLR values, short technique duration (‘time under tension’) and no warm up.