The immediate effect of unilateral lumbar Z-joint mobilisation on posterior chain neurodynamics: A randomised controlled study
Division of Physiotherapy, Faculty of Health Science & Medicine, Bond University, Gold Coast, QLD 4229, Australia.Manual therapy (Impact Factor: 1.71). 07/2011; 16(6):609-13. DOI: 10.1016/j.math.2011.06.004
Hamstring strain (HS) is a common musculoskeletal condition and abnormal neurodynamics has been shown to influence HS and delay recovery. The efficacy of stretching for preventing and treating HS remains uncertain despite extensive research and wide-spread use. The effects of cervical spine mobilisation on peripheral nervous system function, neurodynamics and muscle force in the upper limb have been reported. Very few studies have reported effects of lumbar spine mobilisation on these variables in the lower limb. This study aimed to determine immediate effects of either a unilateral zygopophyseal joint posteroanterior mobilisation or a static posterior chain muscle stretch on the range of passive straight leg raise (SLR) in comparison to a non-treatment control. Using a single-blinded, randomised controlled study design, 36 healthy participants were allocated into one of three groups (control; mobilisation; static posterior chain muscle stretch). Measures of SLR were taken before and after intervention for each group on the day of testing. A General Linear Model (GLM) and a paired sample t-test showed a significant difference between base line and post-intervention for the mobilisation group only (p < 0.001), and suggests that unilateral lumbar spine zygopophyseal joint mobilisation can immediately restore posterior chain neurodynamics.
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- "The researcher practiced the mobilization while listening to the metronome until he became proficient in applying a postero-anterior mobilization at the set frequency of 2 Hz. This was the same dosage as administered to the participants in the Szlezak et al., 2011 "
ABSTRACT: Few studies have reported the effects of lumbar spine mobilization on neurodynamics. In a recent study, Szlezak et al. (2011) reported immediate improvement of posterior chain neurodynamics [range of passive straight leg raise (SLR)] following ipsilateral lumbar spine zygopophyseal (Z) joint mobilization. We re-duplicated the study with a 24 h follow-up measurement. Sixty healthy college students were assigned to two groups, mobilization and control. The mobilization group received ipsilateral grade 3 Maitland mobilizations to Z joint at a frequency of 2 MHz for 3 min and the control group received no treatment. The SLR was measured before and after the intervention for both the groups on the day of testing and 24-h later. Repeated measures ANOVA showed statistically significant pre to post improvement in SLR range after mobilization. The improvement was retained at 24-h. The results of the study are consistent with Szlezak et al. (2011). Copyright © 2014 Elsevier Ltd. All rights reserved.
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ABSTRACT: Recurrent hamstring injuries are a major problem in sports such as football. The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent hamstring injuries and examine the evidence for each intervention. A professional footballer sustained five hamstring injuries in a relatively short period of time. The injury was managed successfully with a seven-point programme-biomechanical assessment and correction, neurodynamics, core stability, eccentric strengthening, an overload running programme, injection therapies and stretching/relaxation. The evidence for each of these treatment options is reviewed. It is impossible to be definite about which aspects of the programme contributed to a successful outcome. Only limited evidence is available in most cases; therefore, decisions regarding the use of different treatment modalities must be made by using a combination of clinical experience and research evidence.
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ABSTRACT: To evaluate the short-term effect on spinal mobility, pain perception, neural mechanosensitivity, and full height recovery after high-velocity low-amplitude (HVLA) spinal manipulation (SM) in the lumbosacral joint (L5-S1) STUDY DESIGN: Randomized, double-blind, controlled clinical trial with evaluations at baseline and after intervention SETTING: University-based physical therapy research clinic PARTICIPANTS: Forty male subjects (N=40) (mean age± SD; 38 ± 9.14 years) diagnosed with degenerative lumbar disease at L5-S1 were randomly divided into two groups: the treatment group (TG) (n = 20) (39 ± 9.12 years) and control group (CG) (n = 20) (37 ± 9.31 years). All participants completed the intervention and follow-up evaluations INTERVENTIONS: A single L5-S1 SM technique (pull-move) was performed in the TG, whereas the CG received a single placebo intervention MAIN OUTCOME MEASURES: Measures included assessing the subject's height using a stadiometer. The secondary outcome measures included perceived low back pain, evaluated using a visual analogue scale; neural mechanosensitivity, as assessed using the passive straight leg raise test (SLR); and amount of spinal mobility in flexion, as measured using the finger to floor distance test (FFD) RESULTS: The intra-group comparison indicated a significant improvement in all variables in the TG (p<.001). There were no changes in the CG, except for the FFD (p=.008). In the between-group comparison of the mean differences from pre- to post-intervention, there was statistical significance for all cases (p<.001) CONCLUSIONS: An HVLA SM in the lumbosacral joint performed on male subjects with degenerative disc disease immediately improves self-perceived pain, spinal mobility in flexion, hip flexion during the passive SLR, and subject's full height. Future studies should include female subjects and should evaluate the long-term results.