Time-course changes associated with PA Lumbar Mobilizations on Lumbar and Hamstring Range of Motion: A Randomized Controlled Crossover Trial

Paul Chesterton, William Evans, Nicholas Livadas, Shaun J. McLaren

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    Abstract

    Objective: To compare the post-intervention time-course changes in Active Knee Extension (AKE) and Active Lumbar Flexion (ALF) range of motion in response to unilateral posterior–anterior (UPA) mobilizations of the lumbar spine (L4/5 zygapophyseal).
    Methods: Twenty-four asymptomatic participants (maleness: 0.58, age [mean ± standard deviation]: 32 ± 8 y, body mass index 25.9 ± 2.6 kg.m2), were recruited to a fully controlled crossover trial. Following either the intervention (L4/5 zygapophyseal mobilizations) or control, participants immediately performed the AKE and ALF tests, which were also performed at baseline. Subsequent tests were made at intervals of 5, 10, 15, 20, 25, 30, 45 and 60 minutes.
    Results: After adjustment for baseline (mean AKE: 37.2 from full extension, mean ALF: 14.37 cm), sex and age, UPA lumbar mobilizations had a most likely moderate effect on AKE (9.8 closer to full extension; ±1.9) and a likely moderate effect on ALF (1.34 cm; ±90% confidence limits 0.43). The magnitude of the AKE effect became most likely small 20-minutes post-treatment (5.3; ±1.7) and possibly small/ possibly trivial 60-minutes post-treatment (2.1; ±1.4). For ALF, the magnitude of the effect became most likely small 15-minutes post-treatment (0.76; ±0.25), possibly small/ possibly trivial 25-minutes post-treatment (0.38; ±0.18), and likely trivial 60-minutes post-treatment (0.26; ±1.8).
    Discussion: UPA lumbar mobilizations increased lumbar ROM and hamstring extensibility by a moderate magnitude, with the effect reducing after 10–20-minutes post-treatment. Clinicians should consider these time-course changes when applying UPA lumbar mobilizations.
    Original languageEnglish
    Number of pages10
    JournalJournal of Manual and Manipulative Therapy
    Early online date13 Nov 2018
    DOIs
    Publication statusE-pub ahead of print - 13 Nov 2018

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