Arch Phys Med Rehabil. 2019 May;100(5):828-836. doi: 10.1016/j.apmr.2018.11.004. Epub 2018 Dec 3.The Effect of Spinal Mobilization With Leg Movement in Patients With Lumbar Radiculopathy-A Double-Blind Randomized Controlled Trial.Satpute K1, Hall T2, Bisen R3, Lokhande P4.Author information1Department of Kinesiotherapy and Physical Diagnosis, Department of Musculoskeletal Physiotherapy, Smt. Kashibai Navale College of Physiotherapy, Pune, Maharashtra, India. Electronic address: kiran_ptist@yahoo.co.in.2School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.3Department of Electrotherapy and Electro Diagnosis, Department of Musculoskeletal Physiotherapy, Smt. Kashibai Navale College of Physiotherapy, Pune, Maharashtra, India.4Department of Orthopaedics, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.AbstractOBJECTIVES:
To evaluate the effect of spinal mobilization with leg movement (SMWLM) on low back and leg pain intensity, disability, pain centralization, and patient satisfaction in participants with lumbar radiculopathy.
DESIGN:A double-blind randomized controlled trial.
SETTING:General hospital.
PARTICIPANTS:Adults (N=60; mean age 44y) with subacute lumbar radiculopathy.
INTERVENTIONS:Participants were randomly allocated to receive SMWLM, exercise and electrotherapy (n=30), or exercise and electrotherapy alone (n=30). All participants received 6 sessions over 2 weeks.
MAIN OUTCOME MEASURES:The primary outcomes were leg pain intensity and Oswestry Disability Index score. Secondary variables were low back pain intensity, global rating of change (GROC), straight leg raise (SLR), and lumbar range of motion (ROM). Variables were evaluated blind at baseline, post-intervention, and at 3 and 6 months of follow-up.
RESULTS:Significant and clinically meaningful improvement occurred in all outcome variables. At 2 weeks the SMWLM group had significantly greater improvement than the control group in leg pain (MD 2.0; 95% confidence interval [95% CI], 1.4-2.6) and disability (MD 3.9; 95% CI, 5.5-2.2). Similarly, at 6 months, the SMWLM group had significantly greater improvement than the control group in leg pain (MD 2.6; 95% CI, 1.9-3.2) and disability (MD 4.7; 95% CI, 6.3-3.1). The SMWLM group also reported greater improvement in the GROC and in SLR ROM.
CONCLUSION:In patients with lumbar radiculopathy, the addition of SMWLM provided significantly improved benefits in leg and back pain, disability, SLR ROM, and patient satisfaction in the short and long term.
Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
KEYWORDS:Low back pain; Manual therapy; Radiculopathy; Rehabilitation
PMID:30521781DOI:10.1016/j.apmr.2018.11.004
