Journal des nouvelles physiothérapies

Abstrait

Comparison of Mulligans Spinal Mobilization with Limb Movement (SMWLM) and Neural Tissue Mobilization for the Treatment of Lumbar Disc Herniation: A Randomized Clinical Trial

Nisar Ahmed, Zainy Khan and Chandan Chawla

Lumbar disc herniation (LDH) with radiculopathy is one of the most common diagnoses encountered in orthopedic clinical practice and it is believed to be a major contributor to the estimated 60-80% lifetime incidence of low back pain. This study was designed to compare the effects of two dissimilar manual therapy techniques viz neural tissue mobilization and Mulligan’s spinal mobilization with limb movement (SMWLM) in patients with L4/L5-L5/S1 lumbar disc herniation associated with radiculopathy. A pre-test post-test experimental design using random sampling was used on 24 patients between 25-60 years of age. Group A patients received neural mobilization with conventional physiotherapy and group B patients received mulligan’s spinal mobilization with limb movement in addition to conventional physiotherapy. The efficacy of the both the treatment groups was assessed using self-report measures namely Numeric pain rating scale (NPRS), Modified Oswestry Disability Index (MODI) and H-Reflex latency which were measured both at baseline and after four weeks of intervention. The results of the study revealed that there was a statistically significant difference between both the groups in terms of pain (p=0.002*) and functional disability (p=0.002*); but no significant post-test difference could be found in H-reflex latency (p=0.632) between groups A and B. This concludes the fact that the neural tissue mobilization group was statistically better than the spinal mobilization with limb movement (SMWLM) group and hence the magnitude of response in relieving pain, improving functional disability and promoting centralization was better in patients who received neural tissue mobilization.