Comparative Effects of Maitland and Mulligan Spinal Mobilizations Along With Canal Enlargement Exercises in Patients of Lumbar Spinal Stenosis
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 38
- 试验地点
- 1
- 主要终点
- Numeric Pain Rating Scale
研究概览
简要总结
This randomised controlled trial will evaluate the comparative effects of Maitland versus Mulligan spinal mobilization techniques, when combined with canal enlargement exercises, in patients with lumbar spinal stenosis (LSS). A total of 38 participants aged 25-40 years with confirmed unilateral LSS will be randomly assigned to receive either Maitland mobilizations or Mulligan mobilizations, along with standard physiotherapy and canal enlargement exercises. The intervention will be administered over three weeks, with four sessions per week. Primary outcomes will include pain intensity (measured by Numeric Pain Rating Scale), disability (Modified Oswestry Disability Index), and symptom severity (Swiss Spinal Stenosis Score), assessed at baseline and post-treatment. This study aims to inform physiotherapy practice by identifying the more effective manual therapy technique for improving functional outcomes in LSS.
详细描述
This single-blinded, randomised controlled trial is designed to compare the effects of two manual therapy techniques, Maitland central posterior-anterior Grade III mobilizations and Mulligan spinal mobilizations (SNAGs), when combined with canal enlargement exercises and conventional physiotherapy. Thirty-eight participants with confirmed unilateral lumbar spinal stenosis will be recruited from the outpatient physiotherapy department at Allama Iqbal Memorial Teaching Hospital, Sialkot.
Participants will be randomly assigned to one of two intervention groups using sealed opaque envelopes. Group A will receive Maitland mobilizations in addition to canal enlargement exercises and conventional physiotherapy, while Group B will receive Mulligan mobilizations along with the same exercise and conventional therapy protocol. The intervention will be administered four times per week over a period of three weeks (total of 12 sessions).
The canal enlargement protocol includes bilateral knee-to-chest exercises, LION stretches, and cat-camel movements, all of which aim to increase lumbar flexion and spinal canal space. Conventional physiotherapy treatment will include the application of hot packs, transcutaneous electrical nerve stimulation (TENS), and stretching of the hamstrings and piriformis muscles.
Primary outcomes will be assessed at baseline and after the 3-week intervention. These include:
Pain intensity (Numeric Pain Rating Scale, NPRS)
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 25 Years 至 40 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age group between 25-40 years
- •Both males and females will be included
- •Patient with low back pain along with unilateral radiating symptoms
- •Having symptoms from at least 3 months with pain severity not more than 7 on NPRS
- •Diagnosed case of slipped disc or herniation causing spinal stenosis, confirmed by physical examination and/or MRI.
排除标准
- •Chronic inflammatory or infectious disease, neoplasm, hematological disorders, traumatic vertebral injuries, Spondylitis
- •Any concurrent major disease like renal failure, diabetes, cancer, tumor.
- •Low back pain with bilateral radiating symptoms.
- •Pregnancy
- •Cognitive alteration and non-co-operative patient
- •Spinal surgery
研究组 & 干预措施
Maitland Mobilization Group
Participants in this group will receive Maitland Grade III central posterior-anterior spinal mobilizations targeting the lumbar spine. The intervention will be administered by a licensed physiotherapist with the patient in a prone position, applying oscillatory mobilization for 3 sets of 40 seconds with 1-minute rest intervals. This will be combined with:
干预措施: Maitland Mobilization Group (Other)
Mulligan Mobilization Group
Participants in this group will receive Mulligan spinal mobilizations with lower limb movement (SNAGs). The therapist will apply sustained passive glides to the lumbar spinous process while the patient actively elevates the leg in a pain-free range. Mobilizations will be performed in 3 sets of 7-10 repetitions. This will be combined with:
干预措施: Mulligan Mobilization Group (Other)
结局指标
主要结局
Numeric Pain Rating Scale
时间窗: Baseline and at the end of 3 weeks (post-intervention)
Pain will be assessed using the 11-point Numeric Pain Rating Scale (NPRS), where 0 represents "no pain" and 10 represents "worst possible pain." The scale is a reliable self-reported tool for evaluating pain intensity in musculoskeletal conditions.
Modified Oswestry Disability Index (MODI)
时间窗: Baseline and at 3 weeks post-intervention
Functional disability will be assessed using the Modified Oswestry Disability Index (MODI), a validated questionnaire that measures the degree of disability related to low back pain. Scores range from 0% (no disability) to 100% (maximum disability).
Swiss Spinal Stenosis Score (SSSS)
时间窗: Baseline and at 3 weeks post-intervention
The Swiss Spinal Stenosis Score (SSSS) will be used to assess symptom severity and physical function specific to lumbar spinal stenosis. The tool includes subscales for symptom intensity and function, with higher scores indicating greater impairment.
次要结局
未报告次要终点