Comparative Study on SNAG From Different Positions Low Back Pain Treatment

Официальное название

Comparative Study on SNAG From Loaded and Unloaded Position in the Treatment of Low Back Pain

Обзор

Background: Low back pain (LBP) is a leading cause of disability worldwide. Mulligan's Sustained Natural Apophyseal Glides (SNAGs) are manual therapy techniques shown to reduce pain and improve function in LBP. However, whether applying SNAGs in loaded (weight-bearing) versus unloaded (non-weight-bearing) positions yields superior clinical outcomes remains unclear. Objective: To compare the effects of lumbar SNAGs applied in loaded versus unloaded positions on pain, disability, and function in individuals with chronic non-specific LBP. Methods: A randomized, single-blind, parallel-group clinical trial will recruit 34 participants with chronic LBP. Participants will be allocated to receive SNAGs in either loaded or unloaded positions, combined with a standardized exercise program, for 6 sessions over 1 week. The primary outcome is pain intensity (Numeric Pain Rating Scale) and lumbar flexion range of motion. Secondary outcomes include disability (Oswestry Disability Index). Outcomes will be measured at baseline and immediately post-treatment. Data will be analyzed using linear mixed models on an intention-to-treat basis. Conclusion: This trial will determine whether a loaded SNAG application provides superior benefits compared to unloaded SNAG in the treatment of chronic LBP. Findings may guide clinical decision-making and optimize manual therapy application.

Вмешательства

• Процедура Loaded-SNAG
  patients will receive SNAGs from standing (Loaded-SNAG), step-stance, or functional position that provokes symptoms. A specialized Mulligan belt was used around the patient's waist and the therapist's hips. The mobilizing force was applied parallel to the facet joint plane (cephalic direction) and over the spinous processes of the respective symptomatic spinal levels. The therapist's hand's ulnar aspect was used over the spinous process of the superior vertebra of the involved segment for flexio
• Процедура Unloaded-SNAG
  patients will receive unloaded SNAG from quadruped position to reduce the axial loading. The therapist applies the equivalent accessory glide at the symptomatic spinal level while the patient performs the symptomatic movement (modified to be non-weight-bearing).

Первичные конечные точки

• Pain intensity [Срок оценки: 1 week]
• Lumbar flexion ROM [Срок оценки: 1 week]

Вторичные конечные точки (1)

• Functional disability [Срок оценки: 1 week]

Критерии участия

Критерии включения

• Chronic non specific low back pain for 6 weeks or more
• Who scored between three and six on a visual analogue scale (VAS)
• Restriction of the movement was only in flexion ROM

Критерии исключения

• Pregnancy,
• Obese,
• Infectious conditions of the spine,
• Autoimmune disorders,
• Malignancy
• Any contraindication to physiotherapy and manual therapy
• Any patient received physical therapy sessions last 6 months

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Саудовская Аравия · 1 центр

• University Medical Clinics — Ha'il

Идентификаторы

NCT: NCT07215286 · H-2025-910

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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