Psychological Predictors of Pain and Disability in Patients With Chronic Low Back Pain After Manual Therapy

Sample A total of 60 people with chronic low back pain will participate in the study and will be divided by lot into two groups of 30 people. The statistical calculation of the sample was made in the following way. We have 5 predictive factors (self-efficacy, depression, kinesiophobia, catastrophism and anxiety) and one predictive factor. According to the regression model we will need 10 people for each variable (i.e. 50 people). However, since we will divide the individuals into 2 groups, in order to have statistical strength in the measurements that will be made, we will take 30 people in each group Participants will be taken through convenience sampling. Participation in the survey will be voluntary and all those who take part will sign a consent form, after detailed information through the information form.

Equipment and Materials The equipment that will be used to conduct the study includes: a) a special electric manual therapy bed, adjustable in height, with recline and hole for the face b) two inclinometers to measure the range of motion of the lumbar spine, c) a mechanical algometer for measuring the pain threshold of the lumbar spine, d) specific questionnaires.

Interventions In both intervention groups, manual therapy based on Maitland's principles (interview, evaluation, mobilization) will be applied without the use of physiotherapy machines, but with the use of therapeutic exercise. The physiotherapist who will apply the techniques is a certified therapist of manual therapy Maitland Concept with 8 years of experience in the application of the method. The number of sessions that each volunteer will receive will be 6, the duration of each session will be about 45 minutes, the frequency of sessions will be 2 times a week and the total duration of the intervention will be 3 weeks.

The International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) defines orthopaedic manual physical therapy as: "a specialized area of physiotherapy for the management of neuromusculoskeletal disorders, based on clinical reasoning, using very specific therapeutic approaches, including manual techniques and therapeutic exercises. Orthopedic hand-held physiotherapy also includes, and is guided by, the available scientific and clinical data and the biopsychosocial context of each individual patient".

The effectiveness of manual therapy in the treatment of low back pain (LBP) has been supported by various studies, indicating its potential benefits in reducing pain, improving impotence and trajectory range. Manual therapy includes techniques such as manipulation and mobilization, which have shown positive results in enhancing range of motion and relieving discomfort in patients with low back pain.