Effects of Mulligan Mobilization and Low-Level Laser Therapy on Physical Disability, Pain, and Range of Motion in Patients with Chronic Low Back Pain: A Pilot Randomized Controlled Trial.

Byoung-Hee Lee,Jung-Hee Kim,U-Hyeok Seo

doi:10.3390/healthcare8030237

Byoung-Hee Lee, Jung-Hee Kim + Show 1 more

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https://doi.org/10.3390/healthcare8030237

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Abstract

This study aimed to determine the combined treatment effects of Mulligan sustained natural apophyseal glides (SNAGs) and low-level laser therapy (LLLT) on function, pain, and range of motion (ROM) in patients with chronic low back pain. A total of 49 adults participated in this study and were randomly divided into three groups (SNAGs with LLLT group, SNAGs group, and control group). The participants in the SNAGs with LLLT group received SNAGs for 10 min, LLLT for 10 min, and electrotherapy for 10 min. The SNAGs group received SNAGs for 10 min and electrotherapy for 20 min. The control group received electrotherapy for 30 min. All participants received the assigned treatment for 30 min a day, 3 times a week, for 4 weeks. We used the visual analogue scale (VAS) to measure pain, the modified-modified Schober test (MMST) to measure ROM, and the Roland Morris disability questionnaire (RMDQ) to measure physical disability. Compared to the pre-intervention values, the VAS and MMST scores significantly increased after the intervention in the SNAGs with LLLT group (p = 0.000) and the SNAGs group (p = 0.000). The RMDQ score significantly improved in the SNAGs with LLLT (p = 0.000), SNAGs (p = 0.000) and control (p = 0.025) group after the intervention. The inter-group differences were greater for the SNAGs with LLLT and SNAGs groups than for the control group (p = 0.001), and the difference was greater for the SNAGs with LLLT than for the SNAGs (p = 0.001) with respect to the VAS, MMST, and RMDQ scores. These results indicate that significant improvement in pain, function, and ROM may be achieved by a combination of SNAGs and LLLT to treat chronic low back pain.

Highlights

Low back pain is a common condition noted in humans
In 10–20% of the cases, back pain develops into chronic low back pain, which is associated with pain and disability persisting for more than 12 weeks [4]
The inter-group differences in the Roland Morris disability questionnaire (RMDQ) score were greater for the sustained natural apophyseal glides (SNAGs) with level laser therapy (LLLT) and SNAGs groups than for the control group, and the difference was greater for the SNAGs with LLLT group than for the SNAGs group (p = 0.001)

Summary

Introduction

Low back pain is a common condition noted in humans. 70–80% of the population experiences low back pain in their lifetime [1,2]. The prevalence of low back pain is consistently increasing. It is an important cause of absenteeism from work and disability, affecting an individual’s socioeconomic status [3]. In 10–20% of the cases, back pain develops into chronic low back pain, which is associated with pain and disability persisting for more than 12 weeks [4]. Specific low back pain is defined as low back pain with a specific pathoanatomic origin, such as a tumor or fracture, and appropriate treatment, such as medication or surgery, is required in such cases.

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