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Journal of Physical Therapy and Sports Medicine
Volume 1, Issue 1 Euro Physiotherapy 2017
Page 25
December 07-08, 2017 Rome, Italy
4th Euro-Global Physiotherapy Congress 2017
Effectiveness of sustained natural
apophyseal glides and Maitland’s
mobilization in facet joint syndrome: A
randomized control trial
Deepak B Anap and Subhash Khatri
PDVVPF’s, College of Physiotherapy, India
Background: Low back pain is a major cause of
disability affecting performance at work. One of the
hidden and less studied culprit of chronic low back pain
is facet joint syndrome. Currently, there is paucity in the
literature regarding the effectiveness of physiotherapy
techniques in treating facet joint syndrome. Hence this
trial was undertaken to study the effectiveness of passive
accessory intervertebral movement (PAIVM) such as
Maitland’s mobilization and passive sustained accessory
mobilization, such as Mulligan’s technique (SNAGs) along
with conventional physiotherapy intervention as compared
to conventional physiotherapy in facet joint syndrome.
Method: A single-blind, randomized control trial was
conducted on participants diagnosed with lumbar
facet joint syndrome. Outcome measures for the study
were Visual analogue scale (VAS), Modified oswestry
disability questionnaire (MODQ), Pressure pain threshold
(PPT), Back muscle endurance, Spinal flexion and
extension ROM. After baseline assessment, participants
were randomly assigned to Group A which received
Mulligans sustained natural apophyseal glides (SNAG’S),
therapeutic ultrasound (Cont.1MHz, 1.5W/cm2) and spinal
exercises, Group B received Maitland’s spinal mobilization
(PA Glides), therapeutic ultrasound and spinal exercises
and Group C received therapeutic ultrasound and spinal
exercises for the period of 2 Wks. Follow up was done at
3rd wk.
Result: Total 186 participants were analyzed using
Kruskal-Wallis test and Dunn-Bonferroni post hoc Test.
K-W test showed a significant difference in all three groups
in terms of VAS, MODQ, PPT and Spinal ROM. Post Hoc
test showed the significant difference (p <0.001) between
SNAGs and Maitland Group in terms of flexion and
extension ROM and there was no significant difference
(p>0.05) between SNAGS and Maitland’s manual therapy
groups in terms of pain, MODQ and PPT.
Conclusion: SNAGs is more effective in improving
spinal ROM, however SNAGs and Maitland’s spinal
mobilization are equally effective in reducing pain,
disability and improving pressure pain threshold. Back
muscle endurance improved in all the three groups, but
the difference was not statistically significant.
Biography
Deepak Anap is currently working as Professor and Head of Musculoskeletal
Physiotherapy Department of DVVPF, College of Physiotherapy, Ahmednagar
( INDIA). He has completed his Ph.D with research in lumbar facet syndrome.
He has published more than 45 research papers and co authored a chapter
in book on radiology. He received long term research grant from Maharshtra
University of health Sciences Nashik for his research on facet joint.
Deepak B Anap et al., J Phys Ther Sports Med 2017