Effectiveness of mobilization with movement (Mulligan concept techniques) on low back pain: a systematic review

Pourahmadi, Mohammadreza; Mohsenifar, Holakoo; Dariush, Mozhdeh; Aftabi, Amirreza; Amiri, Ali

doi:10.1177/0269215518778321

Cited by 26 publications

(28 citation statements)

References 32 publications

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“…; Pourahmadi et al. ). Comparison: Studies were included in which the participants were adult individuals without symptoms of LBP, who had never undergone lumbar spine surgery. Studies were not included in this review when the unaffected side was only considered as a control. Outcomes: Macroscopic morphological changes in hip muscles included the assessment of CSA, FCSA, fat infiltration, fat deposit, muscle density, and muscle volume.…”

Section: Methodsmentioning

confidence: 97%

“…The level of inter‐rater agreement was measured with Cohen's kappa coefficient using a method developed for comparing the level of agreement with categorical data along with their respective 95% confidence intervals (κ 0–0.20 = poor agreement; 0.21–0.40 = fair agreement; 0.41–0.60 = moderate agreement; 0.61–0.80 = good agreement; and 0.81–1 = very good agreement; Pourahmadi et al. ). Any discrepancies were resolved through discussion.…”

Section: Methodsmentioning

confidence: 99%

“…• Participants and Diagnosis: Studies in which participants were adult patients (≥ 18 years) of both genders with LBP. LBP was defined as pain or discomfort on the posterior aspect of the trunk from the lower margin of the 12th ribs to the lower gluteal folds with or without pain referred into one or both lower limbs that lasts for at least 1 day (Hoy et al 2014;Pourahmadi et al 2018b).…”

Section: Eligibility Criteriamentioning

confidence: 99%

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Changes in the macroscopic morphology of hip muscles in low back pain

Pourahmadi

Asadi

Dommerholt³

et al. 2019

Journal of Anatomy

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Low back pain is a major health issue affecting the lumbopelvic muscles. Morphological changes in hip muscles, such as alterations in the muscle cross‐sectional area and muscle volume, may occur in patients with low back pain. This systematic review was conducted to investigate whether patients with low back pain have macroscopic changes in their hip muscle morphology compared with asymptomatic, healthy individuals, based on current evidence. The electronic databases of PubMed/Medline, Ovid, Scopus, Embase®, and Google Scholar were searched from the inception to August 31, 2018. We only included full texts of original studies regarding macroscopic morphological alterations, including atrophy and fat infiltration, in hip muscles of patients with low back pain compared with asymptomatic controls. The quality of the included studies was determined using an assessment tool based on the Newcastle–Ottawa Scale. The scale was modified for the purposes of this study. Sixteen comparative observational studies were found eligible to be included in this review. Eleven were classified as high quality and four as moderate quality. The morphological changes in the psoas major, gluteus maximus, gluteus medius, gluteus minimus, and piriformis muscles were assessed in the primary studies. All selected studies were considered B level of evidence studies. The strength of conclusions for the psoas major, gluteal, and piriformis muscles was moderate. The results revealed that there is substantial controversy about the morphological changes in hip muscles in patients with low back pain; however, the majority of high‐quality studies concluded that atrophy of hip muscles is evident in patients with low back pain. The psoas major muscle was the most commonly investigated hip muscle for morphological changes. Major methodological limitations of the included studies were identified and discussed. The present systematic review does not include a formal meta‐analysis because of very significant differences in the primary studies in terms of study populations and methodologies. Finally, in clinical practice, it is recommended that physical therapists develop exercise programs to improve hip muscle function in patients with low back pain.

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Section: Methodsmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

Section: Eligibility Criteriamentioning

confidence: 99%

See 1 more Smart Citation

Changes in the macroscopic morphology of hip muscles in low back pain

Pourahmadi

Asadi

Dommerholt³

et al. 2019

Journal of Anatomy

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“…However, the control group (0.67 cm) was not clinically important. The effects of SNAGs on VAS score are already well-known [30].…”

Section: Painmentioning

confidence: 99%

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

2020

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This study aimed to determine the combined treatment effects of Mulligan sustained natural apophyseal glides (SNAGs) and low-level laser therapy (LLLT) on function, pain, and range of motion (ROM) in patients with chronic low back pain. A total of 49 adults participated in this study and were randomly divided into three groups (SNAGs with LLLT group, SNAGs group, and control group). The participants in the SNAGs with LLLT group received SNAGs for 10 min, LLLT for 10 min, and electrotherapy for 10 min. The SNAGs group received SNAGs for 10 min and electrotherapy for 20 min. The control group received electrotherapy for 30 min. All participants received the assigned treatment for 30 min a day, 3 times a week, for 4 weeks. We used the visual analogue scale (VAS) to measure pain, the modified-modified Schober test (MMST) to measure ROM, and the Roland Morris disability questionnaire (RMDQ) to measure physical disability. Compared to the pre-intervention values, the VAS and MMST scores significantly increased after the intervention in the SNAGs with LLLT group (p = 0.000) and the SNAGs group (p = 0.000). The RMDQ score significantly improved in the SNAGs with LLLT (p = 0.000), SNAGs (p = 0.000) and control (p = 0.025) group after the intervention. The inter-group differences were greater for the SNAGs with LLLT and SNAGs groups than for the control group (p = 0.001), and the difference was greater for the SNAGs with LLLT than for the SNAGs (p = 0.001) with respect to the VAS, MMST, and RMDQ scores. These results indicate that significant improvement in pain, function, and ROM may be achieved by a combination of SNAGs and LLLT to treat chronic low back pain.

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“…The level of interrater agreement was measured using Cohen kappa coefficient, with a method developed for comparing the level of agreement with categorical data along with their respective 95% confidence intervals (κ = 0-0.20, poor agreement; 0.21-0.40, fair agreement; 0.41-0.60, moderate agreement; 0.61-0.80, good agreement; and 0.81-1, very good agreement). 18 A third reviewer (H.H.) was available to resolve any disagreements that could not be resolved by consensus of the 2 reviewers.…”

Section: Quality Assessmentmentioning

confidence: 99%

Psychometric Properties of the iHandy Level Smartphone Application for Measuring Lumbar Spine Range of Motion and Lordosis: A Systematic Review of the Literature

Pourahmadi¹,

Hesarikia²,

Ghanjal³

et al. 2020

Journal of Sport Rehabilitation

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Context: Advent of smartphones has brought a wide range of clinical measurement applications (apps) within the reach of most clinicians. The vast majority of smartphones have numerous built-in sensors such as magnetometers, accelerometers, and gyroscopes that make the phone capable of measuring joint range of motion (ROM) and detecting joint positions. The iHandy Level app is a free app which has a visual display alike with the digital inclinometer in regard to numeric size. Objective: The purpose of this systematic review was to evaluate available evidence in the literature to assess the psychometric properties (ie, reliability and validity) of the iHandy Level app in measuring lumbar spine ROM and lordosis. Methods: PubMed/MEDLINE, Scopus, Ovid, Google Scholar, and ScienceDirect were searched from inception to September 2018 for single-group repeated-measures studies reporting outcomes of lumbar spine ROM or lordosis in adult individuals without symptoms of low back pain (LBP) or patients with LBP. The quality of each included study was assessed using the Quality Appraisal of Reliability Studies checklist. Results: A total of 4 studies with 273 participants were included. Two studies focused on measuring active lumbar spine ROM, and 2 studies evaluated lumbar spine lordosis. Three studies included asymptomatic subjects, and one study recruited patients with LBP. The results showed that the iHandy Level app has sufficient psychometric properties for measuring standing thoraco-lumbo-sacral flexion, extension, lateral flexion, isolated lumbar spine flexion ROM, and lumbar spine lordosis in asymptomatic subjects. One study reported poor concurrent validity with a bubble inclinometer (r = .19–.53), poor intrarater reliability (intraclass correlation coefficient = .19–.39), and poor to good interrater reliability (intraclass correlation coefficient = .24–.72) for the measurement of active lumbar spine ROM using the iHandy Level app in patients with LBP. Conclusions: This review provided a valuable summary of the research to date examining the psychometric properties of the iHandy Level app for measuring lumbar spine ROM and lordosis.

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Effectiveness of mobilization with movement (Mulligan concept techniques) on low back pain: a systematic review

Abstract: Current evidence is insufficient in supporting the benefits of Mulligan techniques on pain, disability, and range of motion in low back pain patients.

Cited by 26 publications

References 32 publications

Changes in the macroscopic morphology of hip muscles in low back pain

Changes in the macroscopic morphology of hip muscles in low back pain

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

Psychometric Properties of the iHandy Level Smartphone Application for Measuring Lumbar Spine Range of Motion and Lordosis: A Systematic Review of the Literature

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