The effect of mulligan mobilization technique application in addition to conventional physiotherapy on pain and joint range of motion in people with neck pain.

BACKGROUND: To evaluate the effect of the Mulligan mobilization technique on pain intensity and range of motion in individuals with neck pain. METHODS: Forty individuals with mechanical neck pain were enrolled in the study. The patients were randomly divided into 2 groups and a total of 10 sessions of treatment were administered to all 2 groups for 2 weeks, 5 days a week. Mulligan mobilization technique, electrophysical agents, active range of motion, and stretching exercises were carried out in the Mulligan group. In contrast, only electrophysical agents and exercises were applied to the conventional physiotherapy group. Range of motion (ROM) of the neck, Visual Analog Scale (VAS), Neck Pain and Disability Scale (NPDS), and Short-Form 36 Health Survey (SF-36) were used for evaluation. RESULTS: Statistical analyses were done to compare the amounts at the baseline and immediately after treatment. Statistically significant improvements were found in the post-treatment ROM, VAS, NPDS values in both groups (p < 0.05). When the differences were compared, the results of the Mulligan group were significantly better than the conventional physiotherapy group (p < 0.05). There was no significant difference between the groups in terms of SF-36 parameters (p > 0.05). CONCLUSIONS: This study showed that the Mulligan mobilization technique plus conventional physiotherapy is more effective than conventional physiotherapy in increasing joint range of motion, reducing pain, and reducing neck disability. TRIAL REGISTRATON: ClinicalTrials.gov (NCT05074576).

Physiotherapeutic Management for Acromioclavicular Joint Sprain With Volar Intercalated Segment Instability at the Wrist: A Case Report.

Among sports enthusiasts and young individuals, acromioclavicular (AC) joint injuries are highly prevalent. In this, we discussed the comprehensive assessment and management of a 22-year-old male patient who is a student by occupation and a recreational badminton player who presented with left shoulder and wrist pain following a road traffic accident. The study highlights the clinical findings, diagnostic assessment, and therapeutic interventions for the patient with volar intercalated segment instability and a grade 1 AC joint sprain. The methodology involves a case report of the patient's clinical evaluation, including range of motion, manual muscle testing, and diagnostic imaging. The patient was managed conservatively with physiotherapy interventions, including Mulligan's movement with mobilization, cryotherapy, light amplification by stimulated emission of radiation, and progressive exercises. The results of the study demonstrate the successful implementation of a multidisciplinary conservative management approach for alleviating pain, restoring function, and promoting optimal recovery for the patient. The implications of the study underscore the significance of tailored physical therapy rehabilitation in the management of AC joint sprains and wrist instabilities.

Management of Low Back Pain With Concurrent Hamstring Tightness: A Case Report Highlighting the Efficacy of Proprioceptive Neuromuscular Facilitation, Mulligan's Two-Leg Rotation Technique, and Exercise Regimen.

Low back pain (LBP) is a prevalent musculoskeletal issue characterized by discomfort in the lumbosacral region. LBP localized between the 12th thoracic vertebra and inferior gluteal folds is common and often lacks a clear etiology. Various factors contribute to LBP, including increased lumbar lordosis, diminished abdominal muscle strength, reduced back extensor muscle endurance, and flexibility limitations in the back extensors, iliopsoas, and hamstrings. Treatment modalities for LBP encompass surgical intervention, pharmacotherapy, lumbar injections, psychotherapy, chiropractic care, and physiotherapy, with manual therapy being a prominent approach. Physiotherapists employ a spectrum of manual techniques, including mobilization, manipulation, and massage, to address LBP. Hamstring flexibility plays a pivotal role in spinal mechanics, and tight or shortened hamstrings can exacerbate LBP. Mulligan's techniques, notably the two-leg rotation (TLR) technique, are valuable interventions for addressing hamstring tightness in cases of LBP. Proprioceptive neuromuscular facilitation (PNF) was also used to manage pain and improve strength. This case report outlines the management of a 32-year-old male presenting with LBP and hamstring tightness coupled with core muscle weakness. Through comprehensive assessment and physiotherapeutic interventions, significant improvements were observed in pain intensity, lumbar range of motion, disability, straight leg raise (SLR), and core muscle strength following a three-week physiotherapy intervention.

The Therapeutic Efficacy of Ankle Mobilization and Advance Physiotherapy in Alleviating Heel Spur and Plantar Fasciitis: A Case Report.

Plantar fasciitis arises from progressive damage of the plantar fascia, which originates at the medial calcaneal tuberosity and associated perifascial tissues. The plantar fascia is made up of three segments that grow from the calcaneus and serve a crucial role in appropriate foot biomechanics. The plantar fascia itself is vital in supporting the arch and absorbing trauma. The heel spur is one of the most prevalent causes of foot discomfort. It is important to determine the most effective technique of therapy based on the emergence of pain at each step of the day. This case report describes the thorough rehabilitation of a 42-year-old mesomorphic female, a yoga instructor, and a recreational runner who presented with heel spur and plantar fasciitis symptoms. In addition to traditional therapy, the patient received advanced physical therapy with an emphasis on Mulligan joint mobilization to lessen discomfort and increase range of motion. The objective was to evaluate the effect of this intervention on several outcome measures, such as the visual analogue scale, balance test, foot functional scale, range of motion, and lower extremity functional scale. Targeted exercises and treatments were incorporated into the comprehensive rehabilitation plan to enhance foot function. The patient received the enhanced physiotherapy intervention well. The outcome measure showed notable gains. This case contributes greatly to our knowledge of the best physiotherapy treatments for those with plantar fasciitis and heel spurs.

Efficacy of PowerBall Versus Mulligan Mobilization With Movement on Pain and Function in Patients With Lateral Epicondylitis: A Randomized Clinical Trial.

Background Lateral epicondylitis (LE), sometimes referred to as tennis elbow or lateral elbow tendinopathy (LET), is one of the most common repetitive stress disorders in the elbow joint. Often, this involves the attachment of the extensor carpi radialis brevis muscle. This study's primary focus is on treating people with LE, a condition that causes repetitive movements of the upper extremities. There is currently no research on how PowerBall gadget workouts affect the function and pain of individuals with lateral epicondylitis. Exercises using the "PowerBall device," which applies both intrinsic and extrinsic pressure to the wrist, elbow, and shoulder muscles, are thought to be beneficial forms of resistance training. It has been shown that there are improvements in strength, function, range of motion (ROM), discomfort, and quality of life (QOL). On the other side, it has been demonstrated that LE patients have reduced discomfort while using Mulligan Mobilization with Movement (MMWM). Methods The 50 patients with LE were split into two groups for the single-blinded, randomized clinical study after baseline assessment and randomization: Group A was the intervention group, and Group B was the conventional group. The "PowerBall device" exercise was provided to participants in Group A, and MMWM was given to those in Group B. Both groups can benefit from basic workouts and ultrasonography by following the prescribed routine. Quantification of pain, function, grip strength, and range of motion was done at the start and finish of therapy using the Visual Analogue Scale (VAS), Patient Rated Tennis Elbow Evaluation (PRTEE), portable dynamometer, and goniometer. Results After therapy, both groups showed considerable improvement (p<0.05). Both descriptive and inferential statistics were employed in the data analysis. Numerous statistical tests were employed, such as the student's paired and unpaired t-test and the chi-square test. From a statistical and clinical perspective, Group A's outcomes were more significant. On the visual analog scale, there was a decrease in pain intensity for wrist and elbow mobility at rest (p<0.0003), activity (p<0.003), PRTEE (p<0.001), grip strength (p<0.03), and range of motion (p<0.01). Both groups' assessments after rehabilitation indicated increases in pain and function; however, Group A (0.03) benefited more and saw early success with the PowerBall device. Conclusion Findings show that a three-week program incorporating resistance training exercises mediated by a "PowerBall device" enhances upper limb performance beyond traditional exercise treatment and increases grip strength, wrist extension strength, internal and external rotator concentric and eccentric strength. The findings and observations indicate that both groups have significantly improved.

Integrated Rehabilitation Approach Utilizing Swiss Ball Training, Mulligan Taping, and Mobilization With Movement for Simultaneous Management of Sacroiliac Joint Dysfunction and Lateral Ankle Sprain in a Badminton Athlete: A Case Study.

This case report details an integrated rehabilitation plan implemented for a professional badminton player who presented with issues of sacroiliac joint (SIJ) dysfunction and a lateral ankle sprain. The integrated approach aimed to address both musculoskeletal issues, considering their potential reciprocal influences on biomechanics and functional performance. The athlete underwent a thorough initial assessment, including clinical examination, imaging, and biomechanical analysis. Treatment began with targeted interventions for acute ankle sprain management, such as rest, ice, compression, and elevation (RICE) followed by progressive exercises to restore ankle stability and range of motion (ROM). Concurrently, a specialized program was devised to address the underlying sacroiliac joint dysfunction through manual therapy, therapeutic exercises, and core stabilization routines. Throughout the rehabilitation process, the focus remained on integrated exercises that targeted both the ankle and sacroiliac joint, promoting optimal neuromuscular coordination and joint function specific to badminton demands. Regular reassessments guided the progression of interventions, ensuring a personalized and athlete-centric approach. The positive outcome highlights the importance of a holistic rehabilitation strategy in managing complex musculoskeletal conditions in athletes, facilitating efficient recovery, and reducing the risk of recurrence. This case report highlights the effectiveness of an integrated approach in enhancing performance and preventing reinjury in badminton athletes facing multifaceted musculoskeletal challenges.

Integrative Approach of Conventional Physiotherapy, Mulligan's Mobilisation With Movement, and Plyometric Training in a Young Volleyball Athlete After Anterior Cruciate Ligament (ACL) Reconstruction: A Case Report.

The requirements of volleyball include specialized, strategic, and acrobatic skills. In volleyball, it is thus essential to build maximal power and strength properly. Strengthening has been recommended as an effective means to avoid injuries and build muscle strength. It also enhances one's health in relation to performance in the game. Anterior cruciate ligament (ACL) tears are a common knee injury affecting athletes of all levels. A big problem with injury healing and getting back to sports is that there isn't a tried-and-true protocol or set of steps an athlete should follow following an ACL injury. Plyometric training focuses on the core, hip, and thigh muscles to help with appropriate lower limb alignment and recruiting of muscle. We present a 25-year-old male volleyball athlete who suffered from an ACL tear. This case report emphasises how important sports physiotherapy rehabilitation is for athletes. The case report advances the treatment of ACL injury by a multifaceted approach of Mulligan's mobilisation with movement and plyometric-based interventions.

Effectiveness of Recent Physiotherapy Techniques Along With Conventional Physiotherapy Techniques in a Patient With Knee Osteoarthritis: A Case Report.

Osteoarthritis (OA), the most common joint disease, lowers quality of life, restricts social activity participation, and results in incapacity. Osteoarthritis is characterised by changes in subchondral bone, meniscus degeneration, cartilage loss, and synovial inflammation. Physiotherapy plays a vital role in maintaining the stability of this disease. Various treatment approaches have been shown in numerous studies to be successful in improving the condition of individuals with osteoarthritis in the knee. We are presenting a case of a 47-year-old woman who had bilateral osteoarthritis in her knees. We created a six-week treatment plan for this patient that incorporates a number of advanced therapy techniques, including Mulligan mobilisation, Kinesio taping, and plyometric exercise sessions. We created a thorough rehabilitation programme for our patient, who had osteoarthritis in her knee, and it worked incredibly well. We assessed the efficacy of our outcome measures using a variety of outcomes, including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), visual analogue scale (VAS), range of motion (ROM), and manual muscle testing (MMT). It was found to be more beneficial to provide modern physiotherapeutic approaches in addition to a traditional physiotherapy course for improving the overall health and quality of life of the patient.

Macroscopic brain gray matter staining: historical protocol overview and neuroanatomy learning applications in second-year medical students.

Macroscopic staining in anatomical samples of the central nervous system is a technique that has been used for decades to achieve better differentiation of multiple gray matter structures, such as the cortex, basal ganglia, and cerebellar nuclei. Staining methods are based on using the different components of the brain, mainly the lipids present in the white matter. These techniques have been progressively forgotten while computer renderings are increasing; however, as a primary exposure to surgical anatomy, stained brain specimens are considered a helpful tool. We aim to summarize different staining techniques, their principles, and their current applications for neuroanatomy learning purposes. In total, four gray matter staining protocol descriptions (Mulligan's, Roberts's, Alston's, and Prussian Blue) were performed, as well as Likert scale surveys of second-year medical students about their perceptions of the stained sections. The results showed that the different macroscopic stains for brain tissue are based on lipid and reactant interactions, intending to increase the white matter (WM) and gray matter (GM) contrast. The search also showed that most staining protocols would take 2 days to develop. Efficient preservation options include submerging the sections in formaldehyde solutions, formaldehyde-free solutions, ethanol, or applying plastination techniques. Based on the student's perspective, the stained slices seem to be a valuable alternative to facilitate the study and identification of the basal ganglia and their relationships with the white matter (from 51.2 to 72% based on the Likert scale) compared with the non-stained sections. In conclusion, macroscopic staining of brain tissue continues to be a valuable tool for comprehensively studying the brain. Further research is needed to determine the efficacy of stained specimens as teaching tools.

"Mulligan Bent Leg Raise" Technique in Avascular Necrosis.

This case report examines the effectiveness of the "Mulligan bent leg raise" (MBLR) method for treating femoral head avascular necrosis (AVN). A professional physiotherapist directed a six-week rehabilitation program for a 37-year-old male patient with AVN that included this innovative physiotherapeutic method. According to radiographic results and standardized evaluations, the patient showed significant improvements in hip range of motion, functional ability, and pain levels. As a viable supplement to conventional rehabilitation techniques, the MBLR method has shown promise in improving joint function and reducing symptoms in individuals with acute compartment syndrome. The present study provides significant contributions to the discipline. It highlights the necessity for more investigation to examine the wider relevance and enduring effectiveness of this methodology in various population affected.

Promoting Flexibility and Functionality in a Surgically Managed Tibial Fracture: A Case Report on Physiotherapeutic Interventions for Postoperative Stiffness.

This case study explains the complete care of a 45-year-old male patient who had a high-impact road injury that resulted in a displaced proximal tibial fracture. Substantial soft tissue damage was discovered during the initial assessment, requiring careful thought before undergoing surgery. A customized physiotherapy program was instituted after an incremental strategy involving open reduction and internal fixation. The patient made a satisfactory functional recovery, regaining nearly normal mobility and going back to daily activities within 12 weeks despite difficulties encountered during the rehabilitation phase, including temporary postoperative complications. The present study underscores the significance of a multidisciplinary approach involving Mulligan mobilization in the effective management of intricate proximal tibial fractures. It also underscores the importance of meticulous surgical intervention and organized rehabilitation protocols in enhancing patient outcomes and regaining functional abilities to improve patients' quality of life.

Physiotherapy Rehabilitation Strategies for Post-operative Trimalleolar Ankle Fracture: A Case Report.

The trimalleolar fracture of the ankle is the least common type of fracture among ankle fractures. This type of fracture occurs due to high-energy trauma and is seen mostly in females than males. In this case report, we present a 52-year-old female patient who met with a road accident 15 months before presentation. She was brought to the hospital for investigation and was diagnosed with a trimalleolar ankle fracture. She was managed with open reduction and internal fixation using rush nailing and canulated cancellous screws. There was pus discharge from the suture site post-operatively. Due to this, there was a delay in the weight-bearing phase. Medications were given for relief. Ten months post the operation she saw pus discharge from the scar site, she was re-operated for implant removal and physiotherapy was advised. Due to fear of pain, she was not bearing weight on that limb. This prolonged non-weight-bearing phase caused muscle wasting of the right leg, and reduced ankle dorsiflexion range and strength. The patient attended physiotherapy treatment. A Mulligan's movement with mobilization was prescribed to increase the range of ankle dorsiflexion, and ultrasound was used to improve scar mobility. Strength training of lower limb muscles, proprioception training, and gait training was given to the patient. The treatment showed improvement in the range and strength of the lower limb.

Integrated Neuromuscular Inhibition Technique Versus Mulligan Mobilization on Functional Disability in Subjects With Nonspecific Low Back Pain: A Comparative Study.

Background Pain lasting more than three months is termed chronic pain. Treating chronic pain is always a challenge for the therapist. Low back pain (LBP) with a high prevalence is a point of concern. Various treatment methods are available. The two treatment methods are integrated neuromuscular inhibition technique (INIT) and Mulligan mobilization with movement (MWM). In this study, we have compared INIT with MWM. Method It was an interventional study carried out at Ravi Nair Physiotherapy College and Acharya Vinoba Bhave Rural Hospital. A total of 80 participants with nonspecific LBP were included in the study. The participants were randomly divided into two groups and treated for two weeks with three weekly sessions. Statistical analysis and result Statistical analysis was done post the completion of sampling. Paired and unpaired t-tests were used. A p-value of <0.05 was considered significant. The result was obtained after comparing the pre- and post-values of the numerical pain rating scale (NPRS), modified Oswestry disability index (MODI), and range of motion (ROM) of the lumbar joint. After two weeks of treatment, a reduction in functional disability and pain was seen in the INIT and MWM groups. ROM was increased after two weeks of treatment in both INIT and MWM groups. When compared, INIT showed better results than MWM. Conclusion In conclusion, we saw that the integrated neuromuscular inhibition technique might be a better technique than Mulligan mobilization with movement in terms of reducing pain and functional disability.

Effectiveness of Mulligan's Two-Leg Rotation Versus Muscle Energy Technique in Subjects With Hamstring Tightness.

Background Hamstring stiffness has been growing more common, but is often neglected. The hamstring muscle complex is the key and most commonly involved muscle group for stiffness, and the younger generation is particularly susceptible. The tightness causes a limited range of motion and associated consequences. The purpose of this study is to look for the efficacy of Mulligan's two-leg rotation (TLR) and muscle energy technique (MET). Methods To evaluate TLR against MET, an intervention with a duration of six days per week was planned. Modified Oswestry disability questionnaire (MODQ), active knee extension (AKE), lumbar range of motion (LROM), and numerical pain rating scale (NPRS) were used as outcome measures. The duration of the study was six months. It is a pre and post-interventional type of study. Result Statistical analysis was done by using descriptive and inferential statistics using Student's paired and unpaired t-tests. The Statistical Package for Social Sciences (SPSS) version 27 (IBM Corp., Armonk, NY, USA) was used. A p-value <0.05 was considered significant. Both the treatment protocol were beneficial for the patients but TLR yields a more significant reduction in tightness and pain than MET. Conclusion The results after the data analysis show that TLR should be utilized for individuals with hamstring tightness because it exhibited a significant reduction in tightness and pain when compared to MET.

A Review on Treatment Approaches for Chronic Low Back Pain via Mulligans Movement With Mobilization and Physical Therapy.

Low back pain is a leading cause of functional disability. Low back pain is a problem that every one of all age groups faces and there are various methods used to correct low back pain. Manual therapy is a specialized area in physiotherapy which manages neuromuscular pain. Manual therapy techniques include the Maitland mobilization technique, Kaltenborn mobilization technique, Mulligan technique, Active release technique, and many more. Manual therapy mainly works on arthrokinematics and osteokinematics of the joint. It is one of the main strategies used to manage low back pain. Low back pain can be because by spinal dysfunction, Sacroiliac dysfunction, muscle pathology, or any ligamentous strain. The cause of the low back pain should be identified and treated accordingly. Articles using keywords - chronic low back pain, Mulligan, and non-specific low back pain were searched on the database of Pubmed and Scopus a total of 30 articles from the timeframe of 2011 to 2021 were included in the study. From this review, we can conclude that Mulligan mobilization with movement is an effective way to reduce low back pain. Further studies need to be conducted to check the effectiveness of manual therapy techniques in chronic low back pain.

Mobilization With Movement as Therapy to Reduce Knee Pain and Increase Knee Range of Motion.

CLINICAL SCENARIO: Knee pain and limited knee range of motion (ROM) are among the most common conditions found in individuals who report lower body health-related issues. Factors such as weight gain, lack of mobility, balance issues, and pain can lead to a more sedentary lifestyle, which, in turn, causes knee stiffness or knee limited ROM. As a result, the patient will be at higher risk of osteoporosis, patellofemoral pain syndrome, reduced quadriceps strength, heart disease, and even depression. CLINICAL QUESTION: Is mobilization with movement (MWM) an effective method of treatment for reducing knee pain and increasing knee ROM in individuals being treated for knee pain and limited knee ROM? SUMMARY OF KEY FINDINGS: (1) The literature searched were peer-reviewed articles that investigated the effects of MWM as a therapy to reduce knee pain and increase knee ROM. (2) MWM was shown to be an effective treatment for reducing knee pain and increasing knee ROM. CLINICAL BOTTOM LINE: There is conclusive evidence that MWM is an effective method of treatment for reducing knee pain and increasing knee ROM in individuals who experience knee pain and knee limited ROM. STRENGTH OF RECOMMENDATION: Grade ("A") evidence exists showing that MWM therapy results are greater when performed either alone or in combination with a current conventional therapy for decreasing knee pain and increasing knee ROM.

Comparison of Mulligan technique versus muscle energy technique in patients with adhesive capsulitis.

Objectives: To compare the effects of Mulligan technique and muscle energy technique in patients with adhesive capsulitis. METHODS: The randomised controlled trial was conducted at the Department of Physiotherapy, Government Mian Munshi Hospital, Lahore, Pakistan, from September 1, 2019, to March 31, 2020, and comprised patients with adhesive capsulitis who were randomised into Mulligan mobilisation Group A and muscle energy technique Group B. The outcome assessor was kept blinded to the treatment plan. Pain, range of motion and functional disability were measured using Visual Analogue Scale, universal goniometer and Shoulder Pain and Disability Indexat baseline, and subsequently at the end of third and sixth weeks. Data was analysed using SPSS 24. RESULTS: Of the 78 subjects, 39(50%) were in each of the two groups. Group A had 11(28%) male and 28(72%) female patients, while Group B had 20(51%) male and 19(49%) female patients. Both groups showed significant improvement (p<0.001), and inter-group comparison showed the difference to be non-significant at baseline and third week (p>0.05). However, post-intervention difference showed significantly better results in Group A compared to Group B (p<0.05). CONCLUSIONS: Mulligan technique was found to be more effective than muscle energy technique in improving range of motion, and in reducing pain and functional disability. Clinical Trial Number: IRCT 20200605047660.

Effectiveness of Maitland and Mulligan mobilization methods for adults with knee osteoarthritis: A systematic review and meta-analysis.

BACKGROUND: As a serious global problem, knee osteoarthritis (KOA) often leads to pain and disability. Manual therapy is widely used as a kind of physical treatment for KOA. AIM: To explore further the efficacy of Maitland and Mulligan mobilization methods for adults with KOA. METHODS: We searched PubMed, the Cochrane Library, EMbase, Web of Science and Google Scholar from inception to September 20, 2020 to collect studies comparing Maitland and Mulligan mobilization methods in adults with KOA. The quality of the studies was assessed using the Physiotherapy Evidence Database Scale for randomized controlled trials. Data analyses were performed using Review Manager 5.0 software. RESULTS: A total of 341 articles were screened from five electronic databases (PubMed, the Cochrane Library, EMbase, Web of Science and Google Scholar) after excluding duplicates. Ultimately, eight trials involving 471 subjects were included in present systematic review and meta-analysis. The mean PEDro scale score was 6.6. Mulligan mobilization was more effective in alleviating pain [standardized mean difference (SMD) = 0.60; 95% confidence interval (CI): 0.17 to 1.03, P = 0.007; I 2 = 60%, P = 0.020) and improving Western Ontario and McMaster Universities function score (SMD = 7.41; 95%CI: 2.36 to 12.47, P = 0.004; I 2 = 92%, P = 0.000). There was no difference in the effect of the two kinds of mobilization on improving the range of motion (SMD = 9.63; 95%CI: -1.23 to 20.48, P = 0.080; I 2 = 97%, P = 0.000). CONCLUSION: Mulligan mobilization technique is a promising intervention in alleviating pain and improving function score in KOA patients.

Comparing the effects of muscle energy technique and mulligan mobilization with movements on pain, range of motion, and disability in adhesive capsulitis.

OBJECTIVES: To compare the effect of muscle energy technique and Mulligan mobilisation with movement on pain, range of motion and disability in patients of adhesive capsulitis. METHODS: The single-blind, randomised controlled study was conducted at the Physiotherapy Department of Mayo Hospital, Lahore, Pakistan, from July to December, 2018, and comprised patients of either gender aged 30-70 years with adhesive capsulitis stage 2. The subjects were randomised using the lottery method into Mulligan mobilisation with movement group A, and the muscle energy technique grouo B. Conventional treatment, including hot packs and exercises like pulley rope exercise, wall climbing, and shoulder wheel, were part of both the groups. Each technique was applied five times per set, 2 sets per session 3 days a week for three weeks. Baseline and post-intervention readings were recorded for pain, range of motion and disability Using numeric pain rating scale, goniometer, and shoulder pain and disability index. Data was analysed using SPSS 23. RESULTS: Of the 70 individuals assessed, 64(91.4%) were included; 32(50%) in each of the two groups. The mean age in group A was 49.93±6.69 years, while in group B it was 49.17±8.92 years. Group A showed significantly better results compared to group B (p<0.05). CONCLUSIONS: Muscle energy technique and Mulligan mobilisation with movement were both found to be effective, but the latter was significantly better compared to the former. CLINICAL TRIAL NUMBER: IRCT20200611047734N2 (https://www.irct.ir/trial/48851).

Effectiveness of bent leg raise technique and neurodynamics in patients with radiating low back pain.

OBJECTIVE: To compare the effectiveness of bent leg raise technique and neurodynamics in patients with low back pain that radiates up to the knee. METHODS: The pre-test post-test control group study was conducted at Department of Physical therapy, Maqsood Medical Complex and General Hospital Peshawar from February to July 2019. Patients with radiating low back pain of both genders aged 18-60 years were included in the study. Patients were divided into Group-A and Group-B. Group-A patients received Mulligan bent leg raise technique while Group-B patients received neurodynamics. Both groups received five sessions per week, for four weeks. Numeric pain rating scale, Oswestry disability index and goniometer was used to assess pain, functional disability and straight leg raise range before and after the interventions. Data was analyzed using SPSS version 20. RESULTS: Thirty-two participants with mean age of 38.81±9.94 years, participated in the study. There were no significant differences (P-value>0.05) between the two groups at baseline. Post-treatment, within Group-Analysis showed that all three variables (pain, functional disability and straight leg raise range) significantly (P<0.05) improved in both groups. However, post treatment between Group-Analysis showed that there were no significant differences (P>0.05) between the two groups. CONCLUSION: Both neurodynamics and bent leg raise technique significantly improved pain, functional disability and straight leg raise range in patients with low back pain that radiates up to the knee. However, there were no significant differences between the groups who received either neurodynamics or bent leg raise technique.