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Original Research

RMJ. 2021; 46(2): 469-472

Comparison of Mulligan sustained natural apophyseal glides verses Mckenzie extension exercises on disability and functional outcomes in patients with acute nonspecific low back pain

Dileep Kumar Lohana, Umair Ahmad, Faiza Sharif, Ashfaq Ahmad, Amir Ali Geilani, Salwa Atta.


Objective: To compare effectiveness of Mulligan sustained natural apophyseal glides (SNAGs) and McKenzie extension exercises to reduce disability in patients with acute non-specific low back pain.
Methodology: This was double blinded randomized controlled trial was conducted at Gosha E Shifa Hospital, Lahore. We randomized 84 patients through computer number generator and were allocated into group A and B by concealment through envelope. The questionnaire was based on two primary outcome measures i.e. Back performance Scale for ADL’s and Owestry Disability Index for functional disability. Patients were assessed before-treatment i.e. t0, mid treatment i.e. t1 and after treatment i.e. t2.
Results: Mean age for patients in group A was 41.97±8.16 years and in group it was 45.02±7.29 years. Out of 84 patients, 45.24% were males and 54.76% females. Functional abilities measured by Back Performance Scale was found to be 5.02±2.05 and 6.78±3.3 at post treatment level (p=0.00). Back Performance Scale results at 8th week follow up for both groups were 2.15±1.64 and 3.16±2.43, respectively (p=0.03). Functional disability measured by Owestry disability Index was 35.0%±2.21% and 34.3±2.37% at post treatment level (p=0.16). Owestry Disability Index results at 8th week follow up for both groups were 23.62±2.8% and 22.64±2.4%, respectively (p=0.11).
Conclusion: McKenzie exercises and SNAGs both were equally effective in improving pain whereas McKenzie exercises improved functional abilities better than SNAGs.

Key words: McKenzie extension exercises, apophyseal glides, mulligan.

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