The effectiveness of manual therapy and proprioceptive neuromuscular facilitation (PNF) compared with traditional kinesiotherapy in the treatment of non-specific low back pain

Abstract

The aim of the study was to determine whether the use of combination therapy consisting of manual therapy and proprioceptive neuromuscular facilitation (PNF) is more effective than the use of the techniques of manual therapy, PNF method or traditional physiotherapy as single methods in the treatment of symptomatic non-specific low back pain. The study was designed as single-blinded RCT and conducted on a group of 200 patients of the Rehabilitation Ward of Hospital in Parczew. The patients were randomly divided into four 50–person groups: group A used manual therapy, B–PNF, C–manual therapy and PNF, and D–traditional kinesiotherapy. Pain intensity was measured using visual analogue pain scale (VAS) and modified Laitinen's pain questionnaire. The evaluation was carried out four times: before, in the middle of, immediately after and two weeks after completion of therapy. Functional disability was assessed using Oswestry Disability Index (ODI) and Back Pain Functional Scale (BPFS). Assessments were done twice–before and after the treatment. Reduction of pain intensity was statistically significant ( P < 0.05) in all groups at each stage of the study. However, the differences among the groups were not statistically significant ( P > 0.05). In all groups the change in the degree of disability measured by the ODI was statistically significant ( P < 0.05). The improvement in functional ability in patients as measured on the BPFS was statistically significant in all groups ( P < 0.05). Statistically significant differences were noticed between group C and group D ( P < 0.05). 1. All the methods used caused reduction in pain, which lasted for at least 4 weeks. 2. The best improvement in the functional capability of patients was caused by the combined therapy consisted of manual therapy and PNF. 3. The degree of disability as measured in Oswestry Disability Index lowered evenly in all groups.