Hussien Hisham Mohamed, Abdel-Raoof Neveen Abdellatif, Kattabei Omaima Mohamed, Ahmed Hassan Hussien
Basic Science Department, Faculty of Physical Therapy, Cairo University, Al-Giza, Egypt.
Post Graduate Studies and Scientific Research, Faculty of Physical Therapy, Deraya University, El-Minia, Egypt.
J Chiropr Med. 2017 Jun;16(2):94-102. doi: 10.1016/j.jcm.2017.01.003. Epub 2017 Mar 30.
The purpose of this study was to investigate the outcomes of adding lumbar sustained natural apophyseal glide (SNAG) to a conventional therapy program for chronic nonspecific low back pain (LBP).
Forty-two participants with chronic nonspecific LBP were randomly divided into 2 groups. The study group (aged 27.1 ± 8.3, 20 men, 3 women) received a conventional physical therapy program consisted of stretching and strengthening exercises plus SNAG (based on the Mulligan concept) on the affected lumbar levels, and the control group (aged 28.9 ± 7.7, 13 men, 6 women) received the same conventional program without SNAG 3 times per week for 1 month. Outcome measures were repositioning error (the primary outcome), pain, and function measured by an isokinetic dynamometer, visual analog scale, and the Oswestry Disability Index. Measurements were recorded before and after the end of the treatment period.
The comparison between pretreatment and posttreatment test scores indicated that both study and control groups had significant improvement in all dependent variables ( > .001). However, adding SNAG to the conventional program resulted in higher improvement in terms of repositioning error, pain, and function ( = .02, .002, .008) respectively.
This preliminary study indicated improvement in both groups. Adding SNAG to conventional programs in the treatment of chronic nonspecific LBP may result in greater improvement of repositioning error, pain reduction, and improved function.
本研究旨在探讨在慢性非特异性下腰痛（LBP）的传统治疗方案中加入腰椎持续自然小关节滑动（SNAG）的效果。
42名慢性非特异性LBP患者被随机分为两组。研究组（年龄27.1±8.3岁，20名男性，3名女性）接受包括拉伸和强化训练以及在受影响的腰椎节段进行SNAG（基于Mulligan概念）的传统物理治疗方案，对照组（年龄28.9±7.7岁，13名男性，6名女性）接受相同的不含SNAG的传统方案，每周3次，共1个月。结果测量指标为重新定位误差（主要结果）、疼痛以及通过等速测力计、视觉模拟量表和Oswestry功能障碍指数测量的功能。在治疗期结束前后记录测量结果。
治疗前和治疗后测试分数的比较表明，研究组和对照组在所有因变量上均有显著改善（P>.001）。然而，在传统方案中加入SNAG分别在重新定位误差、疼痛和功能方面带来了更高的改善（P = .02、.002、.008）。
这项初步研究表明两组均有改善。在慢性非特异性LBP的治疗中，在传统方案中加入SNAG可能会使重新定位误差得到更大改善、疼痛减轻且功能得到改善。
