Comparative Effectiveness of Mulligan and Maitland Mobilization Techniques Among Patients with Lumbar Facet Joint Syndrome
Article Sidebar
Main Article Content
Abstract
Background: Facet joint syndrome is a prevalent cause of low back pain (LBP), contributing significantly to disability and economic impact. The incidence of lumbar facet joint pain ranges from 7.7% to 75% among LBP patients, highlighting the need for effective treatment options.
Objective: This study aimed to compare the effects of Mulligan's Sustained Natural Apophyseal Glide (SNAG) and Maitland's posteroanterior (PA) glide on pain, range of motion, and functional disability in patients with lumbar facet joint syndrome.
Methods: A single-blind randomized controlled trial was conducted in the outpatient physiotherapy department. Thirty male patients aged 24-60 years with lumbar facet joint syndrome were randomly assigned to two groups: Maitland PA glide and Mulligan SNAGs, each comprising 15 participants. Interventions were administered three times per week for one month. Outcomes were assessed using the Modified Oswestry Disability Questionnaire (MODQ), Numeric Pain Rating Scale (NPRS), and goniometer measurements. Data were analyzed using SPSS 25.
Results: The Maitland group showed significant improvements in MODQ (13.07 ± 3.53, p = 0.023) and NPRS (2.87 ± 1.13, p = 0.025) scores compared to the Mulligan group. Lumbar flexion and extension also improved significantly in the Maitland group (p < 0.05).
Conclusion: The Maitland PA Glide technique demonstrated superior efficacy in reducing pain and improving functional outcomes compared to the Mulligan SNAGs technique in patients with lumbar facet joint syndrome.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Anap DB, Khatri S, Zambre B. Effectiveness of Sustained Natural Apophyseal Glides and Maitland Mobilization in Facet Joint Syndrome: A Single Blind Randomized Control Pilot Study. Int J Health Sci Res. 2014;4:142-50.
Alexander CE, Cascio MA, Varacallo M. Lumbosacral Facet Syndrome. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2017.
Ali MN, Sethi K, Noohu MM. Comparison of Two Mobilization Techniques in Management of Chronic Non-Specific Low Back Pain. J Bodyw Mov Ther. 2019;23(4):918-23.
Bhat V, Patel VD, Eapen C, Shenoy M, Milanese S. Myofascial Release Versus Mulligan Sustained Natural Apophyseal Glides’ Immediate and Short-Term Effects on Pain, Function, and Mobility in Non-Specific Low Back Pain. PeerJ. 2021;9.
Chitale Jr N, Patil DS, Phansopkar P, Joshi A, Chitale NV, Patil Sr DS. A Review on Treatment Approaches for Chronic Low Back Pain via Mulligans Movement With Mobilization and Physical Therapy. Cureus. 2022;14(8).
Cohen SP, Bhaskar A, Bhatia A, Buvanendran A, Deer T, Garg S, et al. Consensus Practice Guidelines on Interventions for Lumbar Facet Joint Pain From a Multispecialty, International Working Group. Reg Anesth Pain Med. 2020;45(6):424-67.
Elgendy MH, Habib AA, Ibrahim RE, Lasheen YR. Mulligan Mobilization Versus Traction in Lumbar Facet Joint Syndrome: Randomized Controlled Trial. Sport TK-Revista Euroamericana de Ciencias del Deporte. 2022;1-1.
Ergan M, Macro M, Benhamou C, Vandermarcq P, Colin T, L'hirondel J, et al. Septic Arthritis of Lumbar Facet Joints. A Review of Six Cases. Rev Rhum Engl Ed. 1997;64(6):386-95.
Hidalgo B, Pitance L, Hall T, Detrembleur C, Nielens H. Short-Term Effects of Mulligan Mobilization With Movement on Pain, Disability, and Kinematic Spinal Movements in Patients With Nonspecific Low Back Pain: A Randomized Placebo-Controlled Trial. J Manipulative Physiol Ther. 2015;38(6):365-74.
Hussien HM, Abdel-Raoof NA, Kattabei OM, Ahmed HH. Effect of Mulligan Concept Lumbar SNAG on Chronic Nonspecific Low Back Pain. J Chiropr Med. 2017;16(2):94-102.
Ibrahim A, Elkeblawy M, Howeidy M, Elkeblawy M, Grase M, Aneis Y. Effect of Maitland Mobilization on Lumbar Proprioception, Pain, and Disability in Patients With Chronic Nonspecific Low Back Pain. Physiotherapy Quarterly. 2021;31(3).
Javaherian M, Tajali SB, Moghaddam BA, Keshtkar AA, Azizi M. Immediate Effects of Maitland Mobilization and Mulligan Techniques on Flexion and Extension Range of Motion in Patients With Chronic Nonspecific Low Back Pain: A Randomized Pilot Study. J Mod Rehabil. 2017;11(2):127-32.
Javed W, Ahmed A, Khalil O, Ikram A, Khalid S. Prevalence of Low Back Pain in Computer Users of Lahore, Pakistan. Asian J Allied Health Sci (AJAHS). 2020;38-41.
Kaur H, Sharma M, Hazari A. Effectiveness of Maitland Mobilization and Mulligan Mobilization in Sacroiliac Joint Dysfunction: A Comparative Study. Crit Rev Phys Rehabil Med. 2019;31(2).
Khan S, Al Torairi N, Shamsi S. Comparative Study of SNAGS and Maitland’s Mobilization in Chronic Low Back Pain. Eur J Phys Educ Sport Sci. 2018;4(9):94-106.
Manzoor T, Arshad N, Nasir N, Zia A. Effect of Modified Lumbar-Sustained Natural Apophyseal Glides (Snags) in Nonspecific Low Back Pain. Saudi J Sports Med. 2019;19(3):86.
Mehta A, Mhatre B, Mote N. Effects of Maitland's Joint Mobilization Versus Shacklock's Neurodynamic Mobilization Techniques in Low Back Pain. Indian J Physiother Occup Ther. 2014;8(2):248.
Mohan Kumar G, Paul J, Sundaram M, Mahendranath P. Comparative Effect of Mulligans Mobilisation Versus Stabilisation Exercise on Chronic Nonspecific Low Back Pain: A Pilot Study. Indian J Public Health Res Dev. 2020;11:1283-8.
Perolat R, Kastler A, Nicot B, Pellat J-M, Tahon F, Attye A, et al. Facet Joint Syndrome: From Diagnosis to Interventional Management. Insights Imaging. 2018;9(5):773-89.
Phelan A, Phelan K, Foley M. Effectiveness of Maitland Spinal Mobilisation Therapy in the Treatment of Non-Specific Low Back Pain–A Prospective Study of Clients Attending a Single Treatment Centre in the Republic of Ireland. Phys Ther Rehabil. 2020;7:1-7.
Pourahmadi MR, Mohsenifar H, Dariush M, Aftabi A, Amiri A. Effectiveness of Mobilization With Movement (Mulligan Concept Techniques) on Low Back Pain: A Systematic Review. Clin Rehabil. 2018;32(10):1289-98.
Seo U-H, Kim J-H, Lee B-H. Effects of Mulligan Mobilization and Low-Level Laser Therapy on Physical Disability, Pain, and Range of Motion in Patients With Chronic Low Back Pain: A Pilot Randomized Controlled Trial. Healthcare. 2020;8(3):237.
Vignesh Bhat P, Patel V, Eapen C, Shenoy M, Milanese S. Myofascial Release Versus Mulligan Sustained Natural Apophyseal Glides’ Immediate and Short-Term Effects on Pain, Function, and Mobility in Non-Specific Low Back Pain. PeerJ. 2021;9.
Waseem A, Manzor N, Fatima I, Yousaf I, Azfar H, Younis H, et al. Comparative Effects of Mulligan’s Mobilization and Proprioceptive Neuromuscular Facilitation Technique on Pain and Disability in Patients With Sacroiliac Joint Dysfunction. Int J Nat Med Health Sci. 2023;1(1):1-5.