Central Posteroanterior Mobilization Research Articles

Immediate Effects of Lumbar Central Posteroanterior Mobilization on Cadence and Gait Speed: A Pilot Study

Immediate Effects of Lumbar Central Posteroanterior Mobilization on Cadence and Gait Speed: A Pilot Study

Immediate Effects of Posteroanterior Cervical Mobilization on Pressure Pain Threshold and Gait Parameters in Patients with Chronic Neck Pain: A Pilot Study

Background: Mobilization and cranio-cervical flexion exercise has been reported in reducing pain from cervical part and improving its motor function; also, has been represented that alleviate of neck pain and recover of neck muscles improve the normal gait performance. However, few studies have identified the effects of mobilization and exercise on pain and gait parameters with preceding issues. Objective: To examine the effects or changes of pressure pain threshold (PPT) and gait parameters in patients with chronic neck pain. Design: Cross-Sectional Clinical Trials Methods: Twenty patients with the history of neck pain (>3 months) performed the cervical mobilization and cranio-cervical flexion exercise. Gait parameters were assessed with wireless device and collected data were transmitted to the personal computer via Bluetooth. The PPT was measured posteroanterior direction at the prone position and the mean of subsequent three PPT meas­urements was used for the final analysis. Results: Both cervical central posteroanterior mobilization (CCPAM) (p<.000) and sling-based cranio-cervical flexion exercise (SBCCFE) (p<.000) group showed a significant increase in the PPT and the gait parameters, cadence (p<.023), was significantly increased in the CCPAM group, however slightly increased in the SBCCFE group. The comparison between the CCPAM and the SBCCFE groups after treatment did not show significant differences for the score on the PPT and gait parameters. Conclusions: This study suggests that CCPAM and SBCCFE increase PPT, cadence, and gait speed.

SPINAL DISPLACEMENT DURING THORACIC SPINAL MANIPULATIVE THERAPY

Background: Vertebrae are linked together with facet and intervertebral joints. The application of a force to a spinal segment therefore impact adjacent areas of the spine. Objective: This study aimed to investigate the posteroanterior (PA) displacement of the thoracocervical spine during the application of thoracic PA mobilization. Methods: Forty-one healthy males were recruited. The participants were asked to lie prone and hold their breath at the end of normal expiration while a therapist applied a grade III of central PA mobilization to the T6 spinous process for 30[Formula: see text]s. The PA spinal displacements of C3, C5, C7, T2, T4 and T6 were investigated using a motion capture system. Descriptive statistics and Pearson’s correlation coefficient were used to analyze the PA spinal displacement and correlation between PA spinal displacement at T6 and the PA displacement of the thoracocervical spines, respectively. Results: The PA displacement of the T6 and the PA displacement of the marked spines (T4, T1, C7, C5 and C3) correlated well with [Formula: see text] being 0.83, 0.69, 0.63, 0.63 and 0.54 ([Formula: see text]), respectively. A trend toward a decrease in spinal displacement was noted when the distance from T6 spine increased. It showed that the mobilization force could be transferred from the local area to an adjacent area. Conclusions: These findings may provide plausible evidence that can explain the mechanism of how thoracic spinal manipulative therapy affects neck pain reduction.

Quantification of Mobilization Grade for Mean Peak Force During Central Posteroanterior Mobilization of C3- C5 in Asymptomatic College Students

The purpose of this study was to measure the mean peak mobilization forces to the cervical spine 3-5 with grade III and grade IV of posteroanterior (PA) mobilization. Asymptomatic 25 college subjects were participated in the trial and eligible physical therapists performed cervical mobilization. The mean peak mobilization force was measured during the PA mobilization with grade III and grade IV by attaching a flexible force transducer over the C3-C5 spinous process. Three cycles of PA mobilization were performed in each spine and the therapist took approximately 2.5s to complete mobilization. After applying the grade III mobilization to the C3-C5, 30 minutes later, the grade IV mobilization was applied to the same area again. There were no significant differences between C3, C4 and C5 during grade III as well as grade IV. Upon comparing the mean peak force of grade III with mean peak force of grade IV at the C3, C4 and C5 respectively, an insignificant difference was also observed. The mean peak mobilization force was 4.53±1.79 N at the C3, 5.10±1.91 N at the C4, and 5.17±2.63 N at the C5 during grade III force was applied. The mean peak mobilization force was 4.40±1.56 N at the C3, 5.53±2.01 N at the C4, and 5.38± 2.73 N at the C5 during grade IV force was applied. This study suggested that the mean peak force of the grade III and grade IV mobilization in the C3-C5 was similar each other, also there was no difference between mean peak force of grade III and grade IV on C3, C4 and C5.

Effect of Central Posteroanterior Mobilization on the Pain, Myotonia, Flexibilty of Trunk Flexion, and Lumbar Lordosis in Patient with Chronic Back Pain: A Case Study

Effect of Central Posteroanterior Mobilization on the Pain, Myotonia, Flexibilty of Trunk Flexion, and Lumbar Lordosis in Patient with Chronic Back Pain: A Case Study

Efficacy of lumbar mobilization on postpartum low back pain in Egyptian females: A randomized control trial.

Low back pain (LBP) is a common complaint in the postnatal period. Physiotherapy has many techniques to apply for such cases. To investigate the effect of central postero-anterior (PA) lumbar mobilization on muscle activity in postpartum LBP. Forty-five females with chronic LBP at least three months postnatal. Participants divided randomly and equally into three groups. Group A (Study group) received PA lumbar mobilization plus traditional treatment which consisted of Ultrasonic and Infra-red. Group B (Placebo group) received placebo mobilization plus traditional treatment. Group C (Control group) received traditional treatment only. All patients received 3 sessions/week for 4 weeks. Pain intensity, functional disabilities and Surface EMG for recording para spinal muscle activity were measured before and after intervention. Statistical analysis was done by ANOVA and paired t-test. Central PA mobilization showed a significant reduction (P< 0.05) in the average surface EMG activity of the erector spinae musculature compared with the other groups as well as improvement in functional ability and reduction in pain intensity. A central PA mobilization significantly reduced pain intensity and surface EMG activity of erector spinae musculature as well as improvement in functional ability in mechanical low back pain in postnatal females.

Immediate effects of thoracic spinal mobilisation on erector spinae muscle activity and pain in patients with thoracic spine pain: a preliminary randomised controlled trial

ObjectivesTo investigate the activity of the thoracic erector spinae muscles and perceived pain intensity immediately after central postero-anterior (PA) mobilisation of the thoracic spine. DesignRandomised, placebo-controlled, experimental design. Participants and interventionsThirty-four participants with non-specific thoracic pain were randomised to the experimental group [grade III central PA mobilisation performed for 3minutes at the level of the seventh thoracic vertebra (T7)] or the placebo group (less than grade I central PA mobilisation performed for 3minutes at T7). Main outcome measuresBefore and immediately after PA mobilisation, surface electromyography (EMG) was recorded from the thoracic erector spinae muscles as the participants performed 10° spine extension from a prone position for 10seconds. Each participant rated their pain intensity as an investigator performed grade III central PA over the most symptomatic thoracic segment, and the pressure pain threshold (PPT) was evaluated bilaterally over the erector spinae muscles. ResultsThe EMG amplitude of thoracic erector spinae activity was reduced significantly after the intervention in the experimental group (P<0.05), but not in the placebo group. The difference between the groups was significant {pre–post change: placebo −14 [standard deviation (SD) 50]mV, experimental 28 (SD 48)mV; mean difference −42mV; 95% confidence interval of the difference −76 to 7; P<0.05} albeit small (Grissom=0.44). However, both groups showed a significant reduction in pain immediately after the intervention, and both groups showed a similar pre–post change in PPT. ConclusionThese preliminary findings indicate that grade III central mobilisation over the most symptomatic thoracic segment reduces thoracic erector spinae activity during extension of the trunk in people with non-specific thoracic spine pain. Clinical trial registration numberISRCTN47601528.

Acute effects of Maitland’s central posteroanterior mobilization on youth with low back pain.

Introduction: The low back pain is the most prevalent between the musculoskeletal disorders, and it is the most common reasons ofabsence from work. The flexibility, mobility, strength and endurance of the low back stability influence and the disharmony betweenthese factors may result in low back pain. One of Maitland’s technique, which alter these factors, is posteroanterior (PA) mobilization.Objective: To analyze the posterior chain’s flexibility, low back’s mobility, trunk extensor’s endurance and low back extensors’ musclestrength after performed one treatment session using the Maitland method on youth with low back pain. Method: For this research,sixteen women (22 ± 3.03 years) with chronic low back pain participated. All volunteers were evaluated according to their perceptionof pain, flexibility, mobility, muscular strength and muscular endurance. The treatment protocol was the application of PA mobilizationon the five lumbar vertebrae, from caudal direction to cranial, of three series of one minute in each vertebra. The same proceduresof the initial evaluation were performed after the immediate application of PA mobilization technique (revaluation 1) and 7 days afterthe protocol (revaluation 2). The data were analyzed by the Shapiro-Wilk’s normality test; analysis of variance (ANOVA) repeatedmeasures one-way with pos-hoc Bonferroni and Friedman’s ANOVA with pos-hoc Wilcoxon, with the level of significance of 5% (p&lt; 0,05).Results: After PA mobilization application, there were significant improvements in muscular strength (immediate post-treatment andpast seven days) and muscular endurance (immediate post-treatment). There were no significant improvements in the other variables,such as, level of pain, and lumbar flexibility and mobility. Conclusion: The lumbar PA mobilization was effective for increasing muscularstrength and endurance, with stabilization of the level of pain, flexibility and mobility.

Changes in Bending Stiffness and Lumbar Spine Range of Movement Following Lumbar Mobilization and Manipulation

Objective The purpose of this study was to investigate the effects of lumbar rotational manipulation and lumbar central posteroanterior mobilization on lumbar bending stiffness and flexion and extension range of motion (ROM). Methods A same-subject, repeated-measures, crossover design was used using 32 asymptomatic subjects (16 female and 16 male; mean [SD] age, 25.5 [4.5] years; weight, 65.7 [11.8] kg; and height, 1.70 [0.08] m). Each subject received mobilization or manipulation on 2 different occasions. Bending stiffness was calculated using a 3-point bending model using an electromagnetic tracking device and a force platform; lumbar flexion and extension ROM was measured using an electromagnetic tracking device. All variables were measured pre- and postintervention. Their effect was compared using paired t tests. Results Manipulation and mobilization did not significantly alter either bending stiffness or lumbar flexion and extension ROM (mobilization: P = .175, P = .613, and P = .535; manipulation: P = .973, P = .323, and P = .439). Bending stiffness changes were not correlated to changes in ROM (Pearson r for stiffness-flexion = −0.102, P = .586; Pearson r for stiffness-extension = 0.014, P = .941). Conclusions Manipulation and mobilization had no significant effect on bending stiffness or flexion and extension ROM for this group of subjects. Some individual variations in effect were observed.

Immediate effects of the central posteroanterior mobilization technique on pain and range of motion in patients with mechanical neck pain

Purpose. To determine the immediate effects of the central posteroanterior (PA) mobilization technique on both pain and active cervical range of motion in patients with mechanical neck pain presenting with central or bilateral symptoms.Methods. A randomized controlled trial was conducted in 60 patients who were randomly allocated into either ‘central PA’ or ‘random’ mobilization group. Two physical therapists and one assessor participated. Outcome measures included neck pain at rest, pain on the most painful movement, and active cervical range of motion taken before and immediately 5 min after the mobilization treatment.Results. Significant reductions in pain at rest and on the most painful movement were noted within-group comparisons (p < 0.001). However, the ‘central PA’ mobilization group obtained a significantly greater reduction in pain on the most painful movement than the ‘random’ mobilization group (p < 0.05). Both mobilization techniques had no effects on the active cervical range of motion. However, the differences in the means of pain reduction between both mobilization techniques were modest (<10 mm).Conclusion. The clinical recommendation regarding the selection of the central PA mobilization technique for treating patients with central or bilateral mechanical neck pain is therefore arguably.

Comparison of surface electromyographic activity of erector spinae before and after the application of central posteroanterior mobilisation on the lumbar spine

Lumbar spine accessory movements, used by therapists in the treatment of patients with low back pain, is thought to decrease paravertebral muscular activity; however there is little research to support this suggestion. This study investigated the effects of lumbar spine accessory movements on surface electromyography (sEMG) activity of erector spinae. A condition randomised, placebo controlled, repeated measures design was used. sEMG measurements were recorded from 36 asymptomatic subjects following a control, placebo and central posteroanterior (PA) mobilisation to L3 each for 2 min. The therapist stood on a force platform while applying the PA mobilisation to quantify the force used. The PA mobilisation applied to each subject had a mean maximum force of 103.3 N, mean amplitude of force oscillation of 41.1 N, and a frequency of 1.2 Hz. Surface electromyographic data were recorded from the musculature adjacent to L3, L5 and T10. There were statistically significant reductions of 15.5% (95% CI: 8.0–22.5%) and 17.8% (95% CI: 12.9–22.4%) in mean sEMG values following mobilisation compared with the control and placebo, respectively. This study demonstrates that a central PA mobilisation to L3 results in a statistically significant decrease in the sEMG activity of erector spinae of an asymptomatic population.

Effect of Vertical Oscillatory Pressure on Neck Pain and Some Cardiovascular Variables

Summary This study aimed to ascertain the immediate response of neck pain to vertical oscillatory pressure (central postero-anterior mobilisation of the spine) and to establish the effect of vertical oscillatory pressure on the cardiovascular system. Fifty subjects (20 with neck pain and 30 pain free) received vertical oscillatory pressure, and their pain intensity before, during and five minutes after treatment was monitored using Borg's ten-point pain rating scale. Their systolic and diastolic blood pressure and heart rate were measured using a digital electronic sphygmomanometer. Rate pressure product was estimated using standard equation ( Kispert, 1987 ). Another 30 pain-free subjects did not receive treatment but had their sensory perception and cardiovascular parameters monitored, using the same posture and technique as for the experimental subjects. Neck pain intensity decreased from severe to mild after treatment and cardiovascular variables did not change significantly. The responses of systolic blood pressure (decrease) and diastolic blood pressure (increase) in neck pain subjects were similar to those of the untreated controls. In contrast, systolic blood pressure (P It was concluded that vertical oscillatory pressure relieved neck pain without significant cardiovascular/myocardial alterations. This implies that vertical oscillatory pressure may be a safe treatment for neck pain even in the presence of mild/moderate cardiovascular impairment.

To compare the effects of different rates of application of a cervical mobilisation technique on sympathetic outflow to the upper limb in normal subjects

SUMMARY. The aim of this study was to compare the effects of different rates of application of a commonly used physiotherapeutic spinal manipulative therapy technique on sympathetic function in normal pain-free volunteers. A randomized, repeated measures, double blind, controlled study design was used to investigate the effects of two different rates of a C5 grade III central postero-anterior mobilization technique on skin conductance (SC) and skin temperature (ST) in the distal C6 dermatome of asymptomatic subjects. Sixteen asymptomatic male volunteers participated in the study. Application of a C5 central postero-anterior grade III mobilization at the rate of 2Hz produced significantly greater increases in SC values than that at the rate of 0.5 Hz and control.The results of this study suggest that mobilization with the rate which is commonly used clinically causes a greater increase in sympathetic efferent activity in the upper limb of normal pain-free volunteers than a slower rate. These results may also provide a basis for further investigation into the physiological effects of different rates of mobilization and in particular exploration of the relationship between changes in sympathetic function following mobilization and manipulation-induced analgesia.