Short-term effects of lumbar posteroanterior mobilization in individuals with low-back pain

Objective: To establish the short-term effects of lumbar posteroanterior mobilization in patients with low-back pain, compared with a control intervention. Design: Self-controlled cross-over design. Main Outcome Measures: The force-displacement characteristics of the spine in response to the application of a posteroanterior force, lumbar flexion, and extension range of movement; pain during flexion, extension, and on worst movement; pain on posteroanterior loading; and overall pain relief. Patients: Twenty-six patients with nonspecific low-back pain who experienced pain on flexion or extension and whose pain settled quickly after provocation, from a physiotherapy clinic and university campus. Methods: Patients received posteroanterior mobilization and a control intervention in an order that was randomly allocated. The magnitude of force in treatment dose was selected by the treating physiotherapist. An observer who was blinded to thr order of interventions performed all measurements. Outcome measures were recorded before and after each intervention, and change scores were calculated to quantify the effect of the intervention. Results: No significant differences were found between the mobilization and control interventions in relation to posteroanterior response or range of movement. The score for pain on worst movement showed significantly greater improvement for the mobilization than fur the control procedure. Conclusions: Lumbar posteroanterior mobilization was not observed to produce any objectively measurable change in the mechanical behavior of the lumbar spine of patients with low-back pain. improvement in some pain variables was observed in comparison with a control procedure, but this may be due to a placebo effect.