Comparison of Passive Translatoric Intervertebral Glides and Manual Segmental Traction in patients with Mechanical Low Back pain: A Randomized Controlled Trial

Authors

  • Mahnoor Zia Physiostherapist, Aziz Bhatti Hospital, Gujrat, Pakistan
  • Zainab Noor Qazi Lecturer, Margalla Institute of Health Sciences, Rawalpindi, Pakistan
  • Sana Javaid Consultant physical therapist, Healing Hands Mega Medical Complex Rawalpindi, Pakistan
  • Huma Mehrin Khan Physiotherapist, Behavior and Special Education Services (BASES), Rawalpindi, Pakistan
  • Shakeel Ahmad Department of Physical Therapy and Health Rehabilitation, Al Jouf University, Sakkaka, Saudi Arabia.

Abstract

Background: Low back pain is a global health issue and leading cause of disability. It is frequently treated by using manual treatments in physiotherapy clinics including mobilizations and spinal traction.

Objective: To determine and compare the effects of joint mobilizations and manual spinal traction on pain, disablity and joint range of motion in mechanical low back pain

Methodology: In the Physiotherapy Department of Aziz Bhatti Hospital, Gujrat, 34 participants with the complaint of diagnosed and confirmed cases of mechanical low back pain, aged 25 to 65 years were split into two equal groups for a randomized clinical trial. Group A received Passive Translatoric Intervertebral Glides while Group B received Manual Lumbar Traction (MLT) and both received conventional core stability exercises. Data was gathered using Numeric Pain Rating Scale (NPRS), Modified Oswestry Diability Index (MODI), and a universal goniometer at baseline, 2nd week and 4th week using Non-probability convenient sampling technique. SPSS version 22 was used for data analysis. (Clinical Trial Registry Number: NCT05522543)

Results: A significant improvement in pain, disability and range of motion was seen in both groups at the 4th week of intervention (p< 0.001). However, Group B (MLT) showed more improvement in NPRS compared with Group A (PTIG). Both the treatment groups including PTIG (p< 0.001) and MLT (p< 0.001) showed significant reduction in disability scores however no statistically significant difference was found in inter-group analysis for disability score (p=0.274), Flexion(p=0.610) or Extension (p=0.170).

Conclusion: The study concluded that both treatments are effective in lowering the pain, disability and improving lumbar range of motion. However, significant improvement was found in group B in reducing pain, while overall no significant group differences were observed.

Keywords: Joint range of motion, Mechanical low back pain, Mobilizations, Traction

References

Will JS, Bury DC, Miller JA. Mechanical low back pain. American family physician. 2018;98(7):421-8.

Edwards J, Hayden J, Asbridge M, Magee K. The prevalence of low back pain in the emergency department: a descriptive study set in the Charles V. Keating Emergency and Trauma Centre, Halifax, Nova Scotia, Canada. BMC musculoskeletal disorders. 2018; 19:1-10.

Mansfield KE, Sim J, Jordan JL, Jordan KP. A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population. Pain. 2016;157(1):55-64.

Oostinga D, Steverink JG, van Wijck AJ, Verlaan J-J. An understanding of bone pain: A narrative review. Bone. 2020; 134:115272.

Qaseem A, Wilt TJ, McLean RM, Forciea MA, Physicians* CGCotACo. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of internal medicine. 2017;166(7):514-30.

Seo U-H, Kim J-H, Lee B-H, editors. 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. Healthcare; 2020: MDPI.

Asiri F, Tedla J, Alshahrani M, Ahmed I, Reddy R, Gular K. Effects of patient-specific three-dimensional lumbar traction on pain and functional disability in patients with lumbar intervertebral disc prolapse. Nigerian journal of clinical practice. 2020;23(4):498-502.

Outeda LR, Cousiño LAJ, Carrera IdC, Caeiro EML. Effect of the maitland concept techniques on low back pain: a systematic review. Coluna/Columna. 2022;21(2): e258429.

Cairns MC, Foster NE, Wright C. Randomized controlled trial of specific spinal stabilization exercises and conventional physiotherapy for recurrent low back pain. LWW; 2006.

Ali MN, Sethi K, Noohu MM. Comparison of two mobilization techniques in management of chronic non-specific low back pain. Journal of bodywork and movement therapies. 2019;23(4):918-23.

Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test–retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. Journal of pain research. 2018:851-6.

Ganzalez GZ, Costa LdCM, Garcia AN, Shiwa SR, Amorim CF, Costa LOP. Reproducibility and construct validity of three non-invasive instruments for assessing the trunk range of motion in patients with low back pain. Fisioterapia e Pesquisa. 2014;21(4):365-71.

Grönblad M, Hupli M, Wennerstrand P, Järvinen E, Lukinmaa A, Kouri J-P, et al. Intercorrelation and test-retest reliability of the Pain Disability Index (PDI) and the Oswestry Disability Questionnaire (ODQ) and their correlation with pain intensity in low back pain patients. The Clinical journal of pain. 1993;9(3):189-95.

Karimi N, Akbarov P, Rahnama L. Effects of segmental traction therapy on lumbar disc herniation in patients with acute low back pain measured by magnetic resonance imaging: a single arm clinical trial. Journal of back and musculoskeletal rehabilitation. 2017;30(2):247-53.

Diab AA, Moustafa IM. Lumbar lordosis rehabilitation for pain and lumbar segmental motion in chronic mechanical low back pain: a randomized trial. Journal of manipulative and physiological therapeutics. 2012;35(4):246-53.

Ikram A, Farooq N, Khan U, Muhammad A, Niaz M,Mehmood A. Effect of Postero-Anterior LumberSpine Mobilization versus McKenzie Press-Ups in Non-Specific Low Back Pain. Pakistan Journal ofMedical Health Sciences. 2021 Sep; 15(9): 1-3

Ali MN, Sethi K, Noohu MM. Comparison of two mobilization techniques in management of chronic non-specific low back pain. Journal of bodywork and movement therapies. 2019;23(4):918-23

Downloads

Published

2025-12-23

How to Cite

1.
Zia M, Qazi ZN, Javaid S, Khan HM, Ahmad S. Comparison of Passive Translatoric Intervertebral Glides and Manual Segmental Traction in patients with Mechanical Low Back pain: A Randomized Controlled Trial. J Riphah Coll. Rehabili. sci. [Internet]. 2025Dec.23 [cited 2025Dec.27];13(4). Available from: https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2642

Issue

JRCRS Volume 13 Issue 4

Section

Original Articles

License

Copyright (c) 2025 All Articles are made available under a Creative Commons "Attribution-NonCommercial 4.0 International" license. (https://creativecommons.org/licenses/by-nc/4.0/). Copyrights on any open access article published by Journal Riphah college of Rehabilitation Science (JRCRS) are retained by the author(s). Authors retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means; provided the article is correctly cited. JRCRS does not allow commercial use of the articles published. All articles published represent the view of the authors and do not reflect the official policy of JRCRS.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.