Background: A common treatment used by physiotherapists for patients with low back pain is mobilisation. The aim of applying mobilisation treatment is to increase range of movement and reduce pain and stiffness. Therapists choose a specific dose of mobilisation for each patient, which includes a decision on the duration of applied force, commonly up to 3minutes. Little research has been done to determine the effects of different durations of treatment. There is tentative evidence that increased duration beyond 3minutes leads to a decrease in pain. Purpose: This study aimed to establish the analgesic effects of short and long durations of lumbar mobilisation treatment. Methods: A randomised placebo controlled trial was conducted to establish the immediate and short-term (24hours after treatment) analgesic effects of different duration of lumbar mobilisation in participants with LBP. Comparisons of pressure pain threshold (PPT), verbal rating scale (VRS) of pain were made immediately after a placebo-control intervention and 2minutes of mobilisation treatment, and immediately and 24-hours after 1 and 6minutes of mobilisation treatment. Results: Analysis of treatment responders demonstrated that significantly more participants receiving longer duration of treatment experienced a reduction in PPT local to the site of treatment (p=.001). Overall, there was no significant difference between treatment groups. Verbal rating of pain on movement was significantly reduced after treatment (p<.01) but the difference between treatment groups did not reach significance. There was dissociation between participants’ verbal rating of pain and PPT. Treatment force had a significant mediating effect on pain (p=.01), with greater treatment forces resulting in greater pain reduction local to the site of treatment. Conclusion(s): This study highlighted the varying response of participants to lumbar mobilisation treatment. The difference is response levels and mediating effect of force on PPT were evident local to the site of treatment and not at more distant locations, suggesting that changes in PPT were mediated by a local analgesic mechanism. The dissociation between changes in PPT and verbal rating of pain imply these measures of pain are mediated by different underlying neurobiological mechanisms. Implications: These findings suggest that where pain allows, applying mobilisations for longer and with greater force may result in a greater analgesic effect. The dissociation between PPT and verbal ratings of pain in this study suggest that when investigating the analgesic effects of treatment, it may be important to incorporate a number of pain measures in order to gain wide appreciation of change in pain felt by patients.
|Number of pages
|Published - 2 May 2015
|World Confederation for Physical Therapy Congress 2015 Abstracts - Singapore, 1-4 May, 2015
Duration: 2 May 2015 → …
|World Confederation for Physical Therapy Congress 2015 Abstracts
|2/05/15 → …
- Treatment duration