Time-course changes associated with PA lumbar mobilizations on lumbar and hamstring range of motion: a randomized controlled crossover trial

ABSTRACT

Objective: We aimed 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 years, 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 min.

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-min posttreatment (5.3; ±1.7) and possibly small/possibly trivial 60-min posttreatment (2.1; ±1.4). For ALF, the magnitude of the effect became most likely small 15-min posttreatment (0.76; ±0.25), possibly small/possibly trivial 25-min posttreatment (0.38; ±0.18) and likely trivial 60-min posttreatment (0.26; ±1.8).

Discussion: UPA lumbar mobilizations increased lumbar Range of Motion and hamstring extensibility by a moderate magnitude, with the effect reducing after 10–20-min posttreatment. Clinicians should consider these time-course changes when applying UPA lumbar mobilizations.

Clinical Trials Registry: NCT03273400

Evidence Level: 2b

KEYWORDS:

• Lumbar vertebrae
• mobilizations
• hamstring muscles

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

No funding received.

Notes on contributors

Paul Chesterton

Paul Chesterton is qualified physiotherapist who currently works as a senior lecturer in Sport and Exercise (Sports Rehabilitation). Paul is also a trustee of the Chartered Society of Physiotherapy Charitable Trust and a board member of the North East Musculoskeletal Society (UK). He has published in numerous peer-reviewed journals and is an active reviewer in the field of sports medicine. Prior to teaching, Paul spent a number of years working in professional sport as a physiotherapist, most recently at an English Premier League Football Club.

William Evans

William Evans is a senior lecturer at The University of Sunderland and has a Ph.D in exercise physiology and biomechanics. Will is a certified clinical exercise physiologist with the American College of Sports Medicine. He publishes and reviews in the field of sport science and medicine.

Nick Livadas

Nick Livadas is a senior lecturer in physiotherapy and works clinically in private practice. He has experience of working in both amateur and professional sports medicine and has been an invited speaker at both national and international conferences. He is the current chair of the North East Musculoskeletal Society and previous chair of the Association of Physiotherapists in Orthopaedic Medicine and Injection Therapy.

Shaun J. McLaren

Shaun J. McLaren is a sport scientist with England Rugby League and a research assistant at Leeds Beckett University. He is a probationary Sport and Exercise Scientist with the British Association of Sport and Exercise Sciences and an Accredited Strength and Conditioning Coach with the United Kingdom Strength and Conditioning Association. Shaun regularly publishes and reviews in the field of sport science and medicine.