Abstract
Background. This pilot trial reports the initial estimates of the efficacy of manual therapy interventions in lumbar prolapsed intervertebral disc and determines the feasibility and acceptability of full powered “randomized controlled trial” on efficacy of “spinal mobilization with leg movement (SMWLM)”, high velocity low amplitude thrust (HVLA) and neural mobilization (NM) in lumbar PIVD (Prolapsed Inter-Vertebral Disc) and pilot data will be used to perform sample size calculation for full trial. Material and methods. 48 subjects diagnosed lumbar PIVD were randomly distributed into 4 groups. The primary outcomes were feasibility, assessment procedure, retention rate, adherence and acceptability to the intervention. The secondary outcomes measures were pain, disability and straight leg raise (SLR) range of motion. Results. 90 subjects were screened based on selection criteria. Out of them, 50 (55.55%) were eligible. 48(96%) subjects accepted to participate in study. Baseline data of all the groups was similar but post-intervention score were significant when compared the data between the groups. Highest mean change for visual analog scale (VAS), oswestry disability index (ODI) and SLR were found in SMWLM group. No adverse effects were reported by subjects. Results also suggest that the outcome measures were feasible and acceptable and the treatment considered as the beneficial approach. Conclusions. Present study suggests that it is feasible and acceptable to do a fully powered “randomized controlled trial (RCT)” to evaluate the efficacy of manual therapy interventions in management of lumbar PIVD. This study also reveals that manual therapy interventions are effective in management of lumbar PIVD.
Highlights
Low back pain is identified as a major health issue across the globe and getting worse as reported by “Global Burden of Disease Survey” in 2016 [1]
Highest mean change in straight leg raise (SLR) was shown by SMWLM group (MD = 19.19±1.02; 95%CI -19.84 to -18.55; p < .01) followed by high velocity low amplitude thrust (HVLA) group (MD = 7.64±1.88; 95%CI -8.90 to -6.36; p < .01) after 4 week of intervention (Table 2)
Significant difference were found in mean change in visual analog scale (VAS) score after 4 week of intervention in SMWLM group (MD = 2.34; 95%CI 1.69 to 2.99; p < .01), (MD = 2.83; 95%CI 2.20 to 3.47; p < .01), (MD = 2.16; 95%CI 1.51 to 2.81; p < .01),when compared with HVLA group, neural mobilization (NM) group and CT group respectively
Summary
Low back pain is identified as a major health issue across the globe and getting worse as reported by “Global Burden of Disease Survey” in 2016 [1]. It is most common cause for patients to visit a health professional and most common symptom associated with lumbar disc herniation/prolapse [2,3]. Recent studies show beneficial effects of manual therapy in lumbar disc herniation [5,6,7,8]. The secondary aim was to rule out the initial estimates of the efficacy of manual therapy interventions in lumbar prolapsed intervertebral disc
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