The locked lumbar facet joint: intervention using mobilizations with movement.

Pinehill Hospital, Hitchin, Herts, UK.
Manual Therapy (Impact Factor: 1.76). 06/2001; 6(2):116-21. DOI: 10.1054/math.2001.0394
Source: PubMed
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    ABSTRACT: Abstract Objectives: While studies have looked into the effects of Maitland mobilization on symptom relief, to date, no work has specifically looked at the effects of Mulligan mobilization. The objective of this work was to compare the effectiveness of Maitland and Mulligan's mobilization and exercises on pain response, range of motion (ROM) and functional ability in patients with mechanical neck pain. Methods: A total sample of 60 subjects (21-45 years of age) with complaints of insidious onset of mechanical pain that has lasted for less than 12 weeks and reduced ROM were randomly assigned to: group I - Maitland mobilization and exercises; group - II Mulligan mobilization and exercises; and group-III exercises only, and assessed for dependent variables by a blinded examiner. Results: Post measurement readings revealed statistical significance with time (p < 0.00) and no significance between groups (p > 0.05) indicating no group is superior to another after treatment and at follow-up. The effect sizes between the treatment groups were small. Conclusion: Our results showed that manual therapy interventions were no better than supervised exercises in reducing pain, improving ROM and neck disability.
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    ABSTRACT: Positional faults are considered a possible underlying mechanism mimicking the symptoms of a joint sprain. Despite numerous clinical studies indicating the presence of positional faults, there is limited evidence of imaging studies confirming positional faults. This case report is a preliminary study that offers clinical and ultrasonographic evidence of a proximal positional fault of the radius, treated successfully with manual therapy techniques. Three weeks after a bike fall on the outstretched hand, the patient in this study presented with right wrist pain and a lack of progress with conventional conservative treatment (NSAIDs, rest and immobilization). Clinical findings indicating a proximal positional fault of the radius included pain during active pronation increased by associating a passive movement of the radius in a proximal direction and it was reduced by associating a passive movement of the radius in a distal direction. Ultrasonographic (US) images showed a reduction of radio-capitellar distance on the right side (11.4 mm) compared to the left side (13.3 mm). A positive response with a distal mobilization of the radius supported the proximal positional fault of the radius. After two manual therapy sessions, the patient had recovered normal asymptomatic function. The outcomes used to assess function and pain were active pronation range of motion, the Spanish version of the DASH questionnaire and a 0-10 numeric pain rating scale. Each measure was conducted prior and after each treatment session and one week post treatment. The patient was re-examined at 6 months follow-up, during which US images, demonstrated a normalization of the right radio-capitellar distance.
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    ABSTRACT: Manuscript History: The aim of the present study was to compare the effects between sustained natural apophyseal glides (SNAGs) mobilization and manipulation in the treatment of patients with cervical spine disorders. Forty-nine male patients participated and completed the study. They were randomly assigned into three groups: SNAGs group, manipulation group, and exercise group. Patients in all groups received exercise therapy. The SNAGs group received the specialized SNAGs mobilization. The manipulation group was treated with high-velocity, low-amplitude manipulation. The cervical range of motion (CROM) was measured using CROM device, with the pain assessed using the visual analogue scale (VAS) and the grade of functional recovery measured using the neck disability index (NDI). The patients received two sessions per week for 6 weeks. Evaluations were carried out before treatment, immediately after treatment, and at one month follow up. Repeated measures analysis, Friedman's test, and Wilcoxon signed ranked test respectively revealed a significant increase in ROM, pain reduction, and improved function after treatment and at one-month follow-up. The results showed significant difference in the ROM, VAS, and NDI between the exercise group and both the SNAGs group and the manipulation group. No significant difference was found between the SNAGs group and the manipulation group in terms of ROM, VAS, and NDI after treatment and after one month follow up. The SNAGs mobilization and manipulation were found to be effective treatments more than the exercises alone in the treatment of cervical spine disorders. Copy Right, IJAR, 2014,. All rights reserved.
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