Mulligan Traction Straight Leg Raise: A Pilot Study to Investigate Effects on Range of Motion in Patients with Low Back Pain

Abstract

Mulligan mobilization techniques are frequently used in clinical practice but there is little evidence underlying their use. The aims of this study were to determine the immediate effects of the Mulligan traction straight leg rais etechnique (TSLR) on range of straight leg raise (SLR) in subjects with low back pain (LBP). A further aim was to determine whether the presence of lower-quarter mechano-sensitive neural tissue influenced the outcome. Nineteen subjects with LBP with a unilateral limitation of SLR, sub-classified according to the presence or not of mechano-sensitive lower-quarter neural tissue, were included. On the symptomatic side, range of SLR, hip flexion, and posterior pelvic rotation were recorded at the first onset of pain, using goniometers positioned lateral to the knee and pelvis. Following the intervention, there was a significant increase in range of SLR of 11° (95% confidence interval = 9,13) (F [1,16] = 34.28, p<0.001). This increase was attributed to hip flexion rather than pelvic rotation (F[1,16] = 0.79, p = 0.388). In addition, the presence of mechano-sensitive neural tissue did not significantly influence the outcome (F [1,16] = 0.68, p=0.42). These results provide preliminary evidence for the use of the Mulligan TSLR technique in the management of LBP, when a limitation of SLR is present; however, further controlled studies are required to substantiate these findings.