COMPARATIVE STUDY OF SNAGS AND MAITLAND’S MOBILIZATION IN CHRONIC LOW BACK PAIN

Shabana Khan, Nezar Al Torairi, Sharick Shamsi

Abstract


Objectives: Comparative Study of Snags and Maitland’s Mobilization in Chronic Low Back Pain. Design: Randomized Control Trial. Methodology: A total of 60 patients were included as per pre define inclusion and exclusion criteria and randomly assigned into two groups each having 30 patients. Group A was given SNAG consisted of stretching strengthening and postural correction exercises while Group B was given Maitland’s mobilization consisted of stretching strengthening and postural correction exercises for 4 weeks, 3 sessions per week one session per day. The patient’s outcome measures were assessed by visual analog scale, ODI and Goniometry of Lumbar Range of Motion. Measurements were recorded before and after the end of the treatment period. Results: Results revealed that means and S.D of both group were significant (p=.000 ) statically but clinically the Group of patients treated with SNAGS along with stretching strengthening and postural correction exercises managed pain (pre=7.81±1.16, post=0.35±0.37), ODI(pre= 40±19.18 ,post= 9±4.39)and range of motion (flexion pre=30±6.05,post=51±10.15,extension pre=16±2.33,post=30±5.21 Rt side flexion pre=10±2.15,post=20±4.15 and lt. side flexion pre=10±2.75, post=20±4.53, Rt side rotation pre= 9±1.57,post=18±2.35) lt. side rotation pre=8±2.09,post=17±2.45 better than group of patient treated with Maitland’s mobilization along with stretching strengthening and postural correction exercises in terms of pain (pre=6.27±1.31, post=2.73±1.19), ODI (pre=42±20.52, post=24±11.7) and range of motion (flexion pre=24±5.85, post=36±10.66, extension pre=14±2.35, post=20±5.42, Rt side flexion pre=10±2.45 post=16±2.48, lt Side flexion pre=12±2.85, post=18±2.46, Rt side rotation pre=9±1.80 post=15.±2.81, lt Side rotation pre=8±1.75, post=16±3.27. Conclusion: The result of study suggests that both SNAG and Maitland’s improves the symptoms of chronic low back pain. Better improvement was shown by SNAG group than Maitland’s group. Based on these results SNAG and Exercise should be the treatment of choice for chronic Low back pain rather than Maitland’s with Exercise.

 

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SNAGS, chronic low back pain, Maitland’s, exercise

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Pallavi Chopade, 2018, Comparison of Maitland's mobilisation and Mckenzie therapy in patients with nonspecific low back pain, Int J Biol Med Res.;9(2):6270-6277.

Hoy D., Bain C., Williams G, et al. 2012, A systematic review of the global prevalence of low back pain. Arthritis Rheum. 64(6):2028-2037.

Brosseau L., Milne S., Robinson V., et al. 2002, Efficacy of the transcutaneous electrical nerve stimulation for the treatment of chronic low back pain: a meta-analysis. Spine. 27(6):596-603.

Airaksinen O., Brox J.I., Cedraschi C., et al. 2006 Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006; 15(sup l 2):S192-S300.

Luomajoki H., Saner J. 2012, Movement control impairment as a subgroup of non-specific low back pain. Man Med.; 50(5):387.

Palmer K.T., Walsh K., Bendall H., Cooper C., Coggon D.. 2000, Back pain in Britain: comparison of two prevalence surveys at an interval of 10 years. Bmj. 320(7249):1577-8.

Bogduk N. 2012 Radiological and Clinical Anatomy of the Lumbar Spine. 5th ed ed. China: Churchill Livingstone.

Heliövaara M. 1989 Risk factors for low back pain and sciatica. Annals of medicine. 21(4):257-64.

Heggannavar A., Kale A. 2015, Immediate Effect Of Modified Lumbar Snags In Non-Specific Chronic Low Back Patients: A Pilot Study. Int J Physiother Res. 3(3):1018-23. Available from: http://www.physio-pedia.com/Chronic_Low_Back_Pain.

Burton A.K., Tillotson K.M., Main C.J., Hollis S. 1995, Psychosocial predictors of outcome in acute and subchronic low back trouble. Spine. 20(6):722-8.

Nourah A., A.L. Muhanna, Shabana Khan, 2018 Effectiveness of Snags Mobilization in Chronic Mechanical Low Back Pain, Journal of Advances and Scholarly Researches in Allied Education Vol. XV, Issue No. 6, 153-158.

Chien J.J., Bajwa Z.H. 2008, What is mechanical back pain and how best to treat it? Current pain and headache reports. 12(6):406-11.

Griegel-Morris P., Larson K., Mueller-Klaus K., Oatis C.A. 1992. Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. Physical therapy. 72(6):425-31.

Sueki D.G., Cleland J.A., Wainner RS 2013. A regional interdependence model of musculoskeletal dysfunction: research, mechanisms, and clinical implications. Journal of Manual & Manipulative Therapy. 21(2):90-102.

Hidalgo B., Pitance L., Hall T., Detrembleur C., Nielens H. 2015. Short-Term Effects of Mulligan Mobilization with Movement on Pain, Disability, and Kinematic Spinal Movements in Patients with Nonspecific Low Back Pain: A Randomized Placebo-Controlled Trial. Journal of manipulative and physiological therapeutics.38(6):365-74.

Moutzouri M., Billis E., Strimpakos N., Kottika P., Oldham J.A. 2008. The effects of the Mulligan Sustained Natural Apophyseal Glide (SNAG) mobilisation in the lumbar flexion range of asymptomatic subjects as measured by the Zebris CMS20 3-D motion analysis system. BMC Musculoskeletal disorders. 9(1):1.

Hisham Mohamed Hussien, Neveen Abdellatif Abdel-Raoof, Omaima Mohamed Kattabei, Hassan Hussien Ahmed, 2017 -Effect of Mulligan Concept Lumbar SNAG on Chronic Nonspecific Low Back Pain, Journal of Chiropractic Medicine Volume 16, Issue 2, 94-102.

Sean Hanrahan, Bonnie L. Van Lunen, Michael Tamburello, and Martha L Walker 2005: The Short-Term Effects of Joint Mobilizations on Acute Mechanical Low Back Dysfunction in Collegiate Athletes: J Athl Train. 40(2): 88–93.

Shashank Ghai, Ishan Ghai 2014, Role of various mobilization maneuvers in the management of low back pain, RRBS, 8(10).

Khan Shabana, Shamsi Sharick, Alyaemni Asmaa A.A., Abdelkader Samiha 2013, Effect of Ultrasound and Exercise Combined and Exercise alone in the Treatment of Chronic back pain, IJPOT, Volume: 7, Issue: 2, 202-206.

Clare H.A., Adams R., Maher C.G. 2004: A systematic review of efficacy of McKenzie therapy for spinal pain. Aust J Physiother. 2004; 50(4):209-16. The Lumbar Spine, Mechanical Diagnosis & Therapy: R.A. McKenzie.

Heo M.-Y., Kim K, Hur B.-Y., Nam C.-W. 2015. The effect of lumbar stabilization exercises and thoracic mobilization and exercises on chronic low back pain patients. Journal of physical therapy science. 27(12):3843-6.

Sung Y.-B., Lee J.-H., Park Y.-H. 2014. Effects of thoracic mobilization and manipulation on function and mental state in chronic lower back pain. Journal of physical therapy science. 26(11):1711.

Gong W. 2014 The influence of lumbar joint mobilization on joint position sense in normal adults. J Phys Ther Sci. 26(12): 1985-1987.

Jang J.-S., Lee S.-H., Min J.-H., Maeng D.H. 2009 Influence of lumbar lordosis restoration on thoracic curve and sagittal position in lumbar degenerative kyphosis patients. Spine. 34(3):280-4.

Hayden J.A., van Tulder MW, Malmivaara AV, Koes BW 2005: Meta-analysis: exercise therapy for nonspecific low back pain. Annals of Internal Medicine, 142:765-775.

Priya Singh Rangey, Megha S. Sheth, Neeta J. Vyas, 2015 Comparison of Immediate Effect of Two Different Maitland Mobilization Protocols on Pain and Range Of Motion in Subjects with Osteoarthritis of Knee, IJMHR, Volume: 1, Issue: 2, 26-29.

Melzack R., Wall P.D. Pain mechanisms: a new theory Science 1965; 150:971-979.

Frank C., Akeson W.H., Woo S.L., Amiel D., Coutts R.D. 1984. Physiology and therapeutic value of passive joint motion. Clin Orthop Relat Res, 13-125.

Sambandam C.E., Sailor S.N., Alagesan J. 2011 Effect of Mulligan Mobilization and Maitland Mobilization in Subjects with Unilateral Tibiofemoral Osteoarthritis - Randomized Controlled Trial. Journal of Pharmaceutical and Biomedical Sciences. 11(17).

Mohammad Javaherian, Siamak Bashardoust Tajali, Behrouz Attarbashi Moghaddam, Abbas Ali Keshtkar, Maryam Azizi, 2017, Immediate Effects of Maitland Mobilization and Mulligan Techniques on Flexion and Extension Range of Motion in Patients With Chronic Nonspecific Low Back Pain: A Randomized Pilot Study, JMR, vol. 11, 2, 127-132.

Hidalgo B., Pitance L., Hall T., Detrembleur C., Nielens H. 2015 Short-term effects of Mulligan mobilization with movement on pain, disability, and kinematic spinal movements in patients with nonspecific low back pain: A randomized placebo-controlled trial. Journal of Manipulative and Physiological Therapeutics. 38(6):365-74. doi: 10.1016/j. jmpt.2015.06.013




DOI: http://dx.doi.org/10.46827/ejpe.v0i0.2030

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