Effect of SNAGs on Stiffness of Lumbar Stabilizer Muscles

Istinye University

Status: Completed

Conditions: Manuel Therapy; Low Back Pain

Treatments: Other: Real Sustained Natural Apophyseal Glides (SNAGS); Other: Sham Sustained Natural Apophyseal Glides (SNAGS)

Study type: Interventional

Funder types: Other

Identifiers

NCT04475770

2

Details and patient eligibility

About

Low back pain is a common health problem worldwide. Epidemiological studies have shown that 70-80% of all people are affected at least once in their lifetime. Although it is common, often the cause of the pain has not been determined and is called 'nonspecific low back pain.

Low back pain has been shown to alter the structure of deep and superficial muscles such as multifidus and erector spinae. However, it has not been fully explained how changes in muscle fiber structure affect the biomechanical properties and functions of the muscle.

There are various manual therapy techniques in the treatment of low back pain. Manual therapists use treatment modalities that include passive techniques such as mobilization and manipulation. Mobilization with movement (MWM) developed by Mulligan involves applying a sustained transverse glide to the spinous process of a vertebra while actively or passively performing. These techniques have gained the name "Sustained Natural Apophyseal Glides" (SNAGS) as it is maintained at the pain-free range and follows the plane of the apophyseal joints under treatment.

Ultrasound shear wave elastography (SWE) provides an advantage since it can quantitatively assess tissue elasticity of in vivo skeletal muscles through non-invasive high-frequency ultrasound waves.

The aim of this study was to investigate the acute effect of Mulligan SNAGs on the stiffness of muscle tissue by using Ultrasound shear wave elastography which is an objective assessment technique.

Enrollment: 30 patients

Sex: All

Ages: 18 to 24 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• patients who diagnosed with non-specific low back pain
• between the ages of 18-24
• patients who able to perform at least 40° of trunk flexion

Exclusion criteria

• patients who obese, pregnant, had specific low back pain
• indication for surgery in the past 1 year
• the trauma of lumbar region, and systemic inflammatory disease affecting this area
• exercise and conventional physiotherapy in the last 6 months

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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30 participants in 2 patient groups

Real SNAGs

Experimental group

Description:

Real SNAGs group consists of 16 participants, where the Mulligan concept lumbal SNAGs is applied and evaluations are made before and after.

Treatment:

Other: Real Sustained Natural Apophyseal Glides (SNAGS)

Sham SNAGs

Sham Comparator group

Description:

The Sham SNAGs group consists of 16 participants who performed the same positioning as the Real SNAGs group and evaluated twice with a similar interval without any intervention to the spine.

Treatment:

Other: Sham Sustained Natural Apophyseal Glides (SNAGS)