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Kronik Bel Ağrılı Bireylerde Kayropraktik Manipülasyonu İle Mulligan Mobilizasyonu Tekniğinin Ağrı ve Fonksiyonellik Üzerine Etkisinin Karşılaştırılması

Year 2022, Volume: 6 Issue: 1, 55 - 63, 22.04.2022
https://doi.org/10.46332/aemj.841282

Abstract

Amaç: Çalışmanın amacı, kronik bel ağrısı tanısı almış sağlık çalışanlarında, kayropraktik manipülasyon ve mulligan mobilizasyon tekniği yöntemlerinin ağrı ve fonksiyonellik üzerine etkinliğini karşılaştırmaktır.
Araçlar ve Yöntem: Kronik bel ağrılı, 20-50 yaşları arasındaki (Mulligan grubu 27.70±6.57, Kayropraktik grubu 31.15±8.15) gönüllü 40 birey çalışmaya dahil edilmiştir. Tüm olgular antropometrik olarak değerlendirildikten sonra randomize olarak kayropraktik manipülasyon grubu (KMG) (n:20; 11 kadın, 9 erkek) ve mulligan mobilizasyon grubu (MMG) (n:20; 17 kadın, 3 erkek) olmak üzere 2 gruba ayrılmıştır. Tedavi öncesinde bütün gruplar numerik ağrı skalası (NAS) ve Oswerty bel ağrısı engellilik anketi ile değerlendirilmiştir ve ardından gonyometre ile kalça ve belin normal eklem hareket açıklığına bakılmıştır. Haftada 2 kez, 4 hafta süresince KMG’ye kayropraktik manipülasyon, MMG’ye ise mulligan mobilizasyon tekniği uygulanmıştır. Katılımcılara bu uygulamalar dışında ekstra hiçbir tedavi uygulanmamıştır ve ilave bir aktivite içinde bulunmamalarına özen gösterilmiştir.
Bulgular: Tedavi öncesi ve sonrası olmak üzere 2 farklı zaman diliminde yapılan testlerle uygulamaların etkinlikleri karşılaştırılmıştır. Antropometrik ölçüm değerleri açısından gruplar arasında bir farklılık bulunmamıştır (p>0.05). Grup içi analiz sonuçlarında her iki grupta bütün değerlendirme parametrelerinde anlamlı farklılıklar bulunmuş olup olumlu yönde bir iyileşme görülmüştür (p<0.05). Gruplar arası değerlendirme sonucunda ise MMG ve KMG arasında tedavi öncesi ve sonrası değerler açısından istatistiksel olarak anlamlı bir farklılık bulunmamıştır (p>0.05).
Sonuç: Kronik bel ağrısı tedavisinde kayropraktik manipülasyon ve mulligan mobilizasyon tekniği yöntemleri arasında başarılı sonuçlar açısından bir üstünlük bulunamamıştır. Kronik bel ağrılı hastalarda her iki yöntemin de uygun koşullara göre kullanımı kabul görülmektedir.

Thanks

Gönüllü katılan herkese ve makalede fotoğraf paylaşımına izin veren hastamıza teşekkür ediyoruz.

References

  • 1. Rubin DI. Epidemiology and risk factors for spine pain. Neurologic Clinics. 2007;25(2):353-371.
  • 2. Grabois M. The American congress of rehabilitation medicine: where do we go from here? Arch Phys Med Rehabil. 2003;84(8):1097-1099.
  • 3. Van Tulder M, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions. Spine. 1997;22(18):2128-2156.
  • 4. Liddle SD, Baxter GD, Gracey JH. Exercise and chronic low back pain: what works? Pain. 2004;107(1-2):176-190.
  • 5. Mordeniz C, Sıvacı R. Kronik Bel Ağrısında Medikal Tedavi (Derleme). Kocatepe Tıp Dergisi. 2010;11(1): 43-55.
  • 6. Chou R, Qaseem A, Snow V, et al. Clinical Efficacy Assessment Subcommittee of the American College of Physicians; American College of Physicians; American Pain Society Low Back Pain Guidelines Panel. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med.2007;147(7):478-491.
  • 7. Yıldız, S, Ağaoğlu, M. Dünya Sağlık Örgütü kılavuzları ışığı altında kayropraktik. Integr Tıp Derg. 2013;1(2):73-76.
  • 8. Cooperstein, R. Gonstead chiropractic technique (GCT). Journal of chiropractic medicine. 2003;2(1): 16-24.
  • 9. Exelby L. The Mulligan concept: its application in the management of spinal conditions. Manual therapy. 2002;7(2):64-70.
  • 10. Duymaz T. Mulligan Mobilizasyon Tekniği. Turkiye Klinikleri J Physiother Rehabil-Special Topics. 2015;1(2):16-22.
  • 11. Kankaanpää M, Taimela S, Airaksinen O, et al. The efficacy of active rehabilitation in chronic low back pain: effect on pain intensity, self-experienced disability, and lumbar fatigability. Spine. 1999;24(10):1034-1042.
  • 12. Heymans MW, van Tulder MW, Esmail R, et al. Back schools for nonspecific low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine. 2005;30(19):2153-2163.
  • 13. Hussien HM, Abdel-Raoof NA, Kattabei OM, et al. Effect of Mulligan concept lumbar SNAG on chronic nonspecific low back pain. J Chiropr Med. 2017;16(2):94-102.
  • 14. Wilkey A, Gregory M, Byfield D, et al. A comparison between chiropractic management and pain clinic management for chronic low-back pain in a national health service outpatient clinic. J Altern Complement Med. 2008;14(5):465-473.
  • 15. Heymans MW, van Tulder MW, Esmail R, et al. Back schools for nonspecific low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine. 2005;30(19):2153-2163.
  • 16. Wenban AB, Nielsen MK. Chiropractic maintenance care and quality of life of a patient presenting with chronic low back pain. J Manipulative Physiol Ther. 2005;28(2):136-142.
  • 17. Moseley L. Combined physiotherapy and education is efficacious for chronic low back pain. Aust J Physiother. 2002;48(4):297-302.
  • 18. Niagara WI, Manchikanti, L. Preliminary results of a randomized, equivalence trial of fluoroscopic caudal epidural injections in managing chronic low back pain: Part 3–Post surgery syndrome. Pain Physician. 2008;11(6):817-831.
  • 19. Williams K, Abildso C, Steinberg L, et al. Evaluation of the effectiveness and efficacy of Iyengar yoga therapy on chronic low back pain. Spine. 2009;34(19):2066.
  • 20. Evcik D, Yücel A. Lumbar lordosis in acute and chronic low back pain patients. Rheumatol Int. 2003;23(4):163-165.
  • 21. Ferreira ML, Ferreira PH, Latimer J, et al. Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: a randomized trial. Pain. 2007;(1-2):31-37.
  • 22. Hondras MA, Long CR, Cao Y, et al. A randomized controlled trial comparing 2 types of spinal manipulation and minimal conservative medical care for adults 55 years and older with subacute or chronic low back pain. J Manipulative Physiol Ther. 2009;32(5):330-343.
  • 23. Seo U, Kim JH, Lee BH. Effects of Mulligan Mobilization and Low-Level Laser Therapy on Physical Disability, Pain, and Range of Motion in Patients with Chronic Low Back Pain: A Pilot Randomized Controlled Trial. In Healthcare. 2020;8(3):237.
  • 24. Samir SM, Zak YLA, Soliman MO. Mulligan versus Maitland mobilizations in patients with chronic low back dysfunction. Int J Pharm Tech Res. 2016;9(6):92-99.
  • 25. Cecchi F, Molino-Lova R, Chiti M, et al. Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain: a randomized trial with one-year follow-up. Clin Rehabil. 2010;24(1):26-36.
  • 26. Hidalgo B, Pitance L, Hall T, et al. Short-term effects of Mulligan mobilization with movement on pain, disability, and kinematic spinal movements in patients with nonspecific low back pain: a randomized placebo-controlled trial. J Manipulative Physiol Ther. 2015;38(6):365-374.
  • 27. Waqqar S, Shakil-ur-Rehman S, Ahmad, S. McKenzie treatment versus mulligan sustained natural apophyseal glides for chronic mechanical low back pain. Pak J Med Sci. 2016;32(2):476.
  • 28. Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine J. 2004;4(3):335-356.

Comparison of the Effect of Chiropractic Manipulation and Mulligan Mobilization Technique on Pain and Functionality in Individuals with Chronic Low Back Pain

Year 2022, Volume: 6 Issue: 1, 55 - 63, 22.04.2022
https://doi.org/10.46332/aemj.841282

Abstract

Purpose: This study was to compare the effectiveness of chiropractic manipulation and mulligan mobilization on pain and functionality in health care workers diagnosed with chronic low back pain.
Material and Methods: Forty volunteers aged 20-50 years (Mulligan group (MMG) 27.70±6.57, chiropractic group (CMG) 31.15± 8.15) who were diagnosed with chronic low back pain were included in the study. All cases were randomly divided into two groups as CMG (n:20; 11 females, 9 males) and MMG (n:20; 17 females, 3 males). All treatment groups were evaluated with a numerical pain scale, Oswestry questionnaire, and goniometer. Chiropractic manipulation was applied to CMG and mulligan mobilization was applied to MMG twice a week for 4 weeks. No extra application has been made other than these treatments.
Results: Evaluation was done before and after treatment. There is no difference between groups in terms of anthropometrics. (p>0.05). In-group analysis results showed significant differences in all evaluation parameters in both groups and showed a positive improvement (p<0.05). As a result of the intergroup evaluation, there was no statistically significant difference between MMG and CMG in terms of pre- and post-treatment values (p>0.05).
Conclusion: There was no superiority between chiropractic manipulation and mulligan mobilization techniques in terms of successful results in the treatment of chronic low back pain. The use of both methods according to appropriate conditions is accepted in patients with chronic low back pain.

References

  • 1. Rubin DI. Epidemiology and risk factors for spine pain. Neurologic Clinics. 2007;25(2):353-371.
  • 2. Grabois M. The American congress of rehabilitation medicine: where do we go from here? Arch Phys Med Rehabil. 2003;84(8):1097-1099.
  • 3. Van Tulder M, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions. Spine. 1997;22(18):2128-2156.
  • 4. Liddle SD, Baxter GD, Gracey JH. Exercise and chronic low back pain: what works? Pain. 2004;107(1-2):176-190.
  • 5. Mordeniz C, Sıvacı R. Kronik Bel Ağrısında Medikal Tedavi (Derleme). Kocatepe Tıp Dergisi. 2010;11(1): 43-55.
  • 6. Chou R, Qaseem A, Snow V, et al. Clinical Efficacy Assessment Subcommittee of the American College of Physicians; American College of Physicians; American Pain Society Low Back Pain Guidelines Panel. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med.2007;147(7):478-491.
  • 7. Yıldız, S, Ağaoğlu, M. Dünya Sağlık Örgütü kılavuzları ışığı altında kayropraktik. Integr Tıp Derg. 2013;1(2):73-76.
  • 8. Cooperstein, R. Gonstead chiropractic technique (GCT). Journal of chiropractic medicine. 2003;2(1): 16-24.
  • 9. Exelby L. The Mulligan concept: its application in the management of spinal conditions. Manual therapy. 2002;7(2):64-70.
  • 10. Duymaz T. Mulligan Mobilizasyon Tekniği. Turkiye Klinikleri J Physiother Rehabil-Special Topics. 2015;1(2):16-22.
  • 11. Kankaanpää M, Taimela S, Airaksinen O, et al. The efficacy of active rehabilitation in chronic low back pain: effect on pain intensity, self-experienced disability, and lumbar fatigability. Spine. 1999;24(10):1034-1042.
  • 12. Heymans MW, van Tulder MW, Esmail R, et al. Back schools for nonspecific low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine. 2005;30(19):2153-2163.
  • 13. Hussien HM, Abdel-Raoof NA, Kattabei OM, et al. Effect of Mulligan concept lumbar SNAG on chronic nonspecific low back pain. J Chiropr Med. 2017;16(2):94-102.
  • 14. Wilkey A, Gregory M, Byfield D, et al. A comparison between chiropractic management and pain clinic management for chronic low-back pain in a national health service outpatient clinic. J Altern Complement Med. 2008;14(5):465-473.
  • 15. Heymans MW, van Tulder MW, Esmail R, et al. Back schools for nonspecific low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine. 2005;30(19):2153-2163.
  • 16. Wenban AB, Nielsen MK. Chiropractic maintenance care and quality of life of a patient presenting with chronic low back pain. J Manipulative Physiol Ther. 2005;28(2):136-142.
  • 17. Moseley L. Combined physiotherapy and education is efficacious for chronic low back pain. Aust J Physiother. 2002;48(4):297-302.
  • 18. Niagara WI, Manchikanti, L. Preliminary results of a randomized, equivalence trial of fluoroscopic caudal epidural injections in managing chronic low back pain: Part 3–Post surgery syndrome. Pain Physician. 2008;11(6):817-831.
  • 19. Williams K, Abildso C, Steinberg L, et al. Evaluation of the effectiveness and efficacy of Iyengar yoga therapy on chronic low back pain. Spine. 2009;34(19):2066.
  • 20. Evcik D, Yücel A. Lumbar lordosis in acute and chronic low back pain patients. Rheumatol Int. 2003;23(4):163-165.
  • 21. Ferreira ML, Ferreira PH, Latimer J, et al. Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: a randomized trial. Pain. 2007;(1-2):31-37.
  • 22. Hondras MA, Long CR, Cao Y, et al. A randomized controlled trial comparing 2 types of spinal manipulation and minimal conservative medical care for adults 55 years and older with subacute or chronic low back pain. J Manipulative Physiol Ther. 2009;32(5):330-343.
  • 23. Seo U, Kim JH, Lee BH. Effects of Mulligan Mobilization and Low-Level Laser Therapy on Physical Disability, Pain, and Range of Motion in Patients with Chronic Low Back Pain: A Pilot Randomized Controlled Trial. In Healthcare. 2020;8(3):237.
  • 24. Samir SM, Zak YLA, Soliman MO. Mulligan versus Maitland mobilizations in patients with chronic low back dysfunction. Int J Pharm Tech Res. 2016;9(6):92-99.
  • 25. Cecchi F, Molino-Lova R, Chiti M, et al. Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain: a randomized trial with one-year follow-up. Clin Rehabil. 2010;24(1):26-36.
  • 26. Hidalgo B, Pitance L, Hall T, et al. Short-term effects of Mulligan mobilization with movement on pain, disability, and kinematic spinal movements in patients with nonspecific low back pain: a randomized placebo-controlled trial. J Manipulative Physiol Ther. 2015;38(6):365-374.
  • 27. Waqqar S, Shakil-ur-Rehman S, Ahmad, S. McKenzie treatment versus mulligan sustained natural apophyseal glides for chronic mechanical low back pain. Pak J Med Sci. 2016;32(2):476.
  • 28. Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine J. 2004;4(3):335-356.
There are 28 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Emrah Özcan 0000-0002-6445-5085

Sefa Haktan Hatık 0000-0003-0517-4600

Demet Tekin 0000-0002-7508-104X

Publication Date April 22, 2022
Published in Issue Year 2022 Volume: 6 Issue: 1

Cite

APA Özcan, E., Hatık, S. H., & Tekin, D. (2022). Kronik Bel Ağrılı Bireylerde Kayropraktik Manipülasyonu İle Mulligan Mobilizasyonu Tekniğinin Ağrı ve Fonksiyonellik Üzerine Etkisinin Karşılaştırılması. Ahi Evran Medical Journal, 6(1), 55-63. https://doi.org/10.46332/aemj.841282
AMA Özcan E, Hatık SH, Tekin D. Kronik Bel Ağrılı Bireylerde Kayropraktik Manipülasyonu İle Mulligan Mobilizasyonu Tekniğinin Ağrı ve Fonksiyonellik Üzerine Etkisinin Karşılaştırılması. Ahi Evran Med J. April 2022;6(1):55-63. doi:10.46332/aemj.841282
Chicago Özcan, Emrah, Sefa Haktan Hatık, and Demet Tekin. “Kronik Bel Ağrılı Bireylerde Kayropraktik Manipülasyonu İle Mulligan Mobilizasyonu Tekniğinin Ağrı Ve Fonksiyonellik Üzerine Etkisinin Karşılaştırılması”. Ahi Evran Medical Journal 6, no. 1 (April 2022): 55-63. https://doi.org/10.46332/aemj.841282.
EndNote Özcan E, Hatık SH, Tekin D (April 1, 2022) Kronik Bel Ağrılı Bireylerde Kayropraktik Manipülasyonu İle Mulligan Mobilizasyonu Tekniğinin Ağrı ve Fonksiyonellik Üzerine Etkisinin Karşılaştırılması. Ahi Evran Medical Journal 6 1 55–63.
IEEE E. Özcan, S. H. Hatık, and D. Tekin, “Kronik Bel Ağrılı Bireylerde Kayropraktik Manipülasyonu İle Mulligan Mobilizasyonu Tekniğinin Ağrı ve Fonksiyonellik Üzerine Etkisinin Karşılaştırılması”, Ahi Evran Med J, vol. 6, no. 1, pp. 55–63, 2022, doi: 10.46332/aemj.841282.
ISNAD Özcan, Emrah et al. “Kronik Bel Ağrılı Bireylerde Kayropraktik Manipülasyonu İle Mulligan Mobilizasyonu Tekniğinin Ağrı Ve Fonksiyonellik Üzerine Etkisinin Karşılaştırılması”. Ahi Evran Medical Journal 6/1 (April 2022), 55-63. https://doi.org/10.46332/aemj.841282.
JAMA Özcan E, Hatık SH, Tekin D. Kronik Bel Ağrılı Bireylerde Kayropraktik Manipülasyonu İle Mulligan Mobilizasyonu Tekniğinin Ağrı ve Fonksiyonellik Üzerine Etkisinin Karşılaştırılması. Ahi Evran Med J. 2022;6:55–63.
MLA Özcan, Emrah et al. “Kronik Bel Ağrılı Bireylerde Kayropraktik Manipülasyonu İle Mulligan Mobilizasyonu Tekniğinin Ağrı Ve Fonksiyonellik Üzerine Etkisinin Karşılaştırılması”. Ahi Evran Medical Journal, vol. 6, no. 1, 2022, pp. 55-63, doi:10.46332/aemj.841282.
Vancouver Özcan E, Hatık SH, Tekin D. Kronik Bel Ağrılı Bireylerde Kayropraktik Manipülasyonu İle Mulligan Mobilizasyonu Tekniğinin Ağrı ve Fonksiyonellik Üzerine Etkisinin Karşılaştırılması. Ahi Evran Med J. 2022;6(1):55-63.

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