Comparison of Mulligan sustained natural apophyseal glides verses Mckenzie extension exercises on disability and functional outcomes in patients with acute nonspecific low back pain

Objective: To compare effectiveness of Mulligan sustained natural apophyseal glides (SNAGs) and McKenzie extension exercises to reduce disability in patients with acute non-specific low back pain. Methodology: This was double blinded randomized controlled trial was conducted at Gosha E Shifa Hospital, Lahore. We randomized 84 patients through computer number generator and were allocated into group A and B by concealment through envelope. The questionnaire was based on two primary outcome measures i.e. Back performance Scale for ADL’s and Owestry Disability Index for functional disability. Patients were assessed before-treatment i.e. t0, mid treatment i.e. t1 and after treatment i.e. t2. Results: Mean age for patients in group A was 41.97±8.16 years and in group it was 45.02±7.29 years. Out of 84 patients, 45.24% were males and 54.76% females. Functional abilities measured by Back Performance Scale was found to be 5.02±2.05 and 6.78±3.3 at post treatment level (p=0.00). Back Performance Scale results at 8th week follow up for both groups were 2.15±1.64 and 3.16±2.43, respectively (p=0.03). Functional disability measured by Owestry disability Index was 35.0%±2.21% and 34.3±2.37% at post treatment level (p=0.16). Owestry Disability Index results at 8th week follow up for both groups were 23.62±2.8% and 22.64±2.4%, respectively (p=0.11). Conclusion: McKenzie exercises and SNAGs both were equally effective in improving pain whereas McKenzie exercises improved functional abilities better than SNAGs.