Chesterton Paul, Evans William, Livadas Nick, McLaren Shaun J
a Department of Physiotherapy, Sport Rehabilitation, Dietetics and Leadership , Teesside University , Middlesbrough , UK.
b Faculty of Health Sciences and Wellbeing , Sunderland University , UK.
J Man Manip Ther. 2019 May;27(2):73-82. doi: 10.1080/10669817.2018.1542558. Epub 2018 Nov 13.
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).
Twenty-four asymptomatic participants (maleness: 0.58, age [mean ± standard deviation]: 32 ± 8 years, body mass index 25.9 ± 2.6 kg m) 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.
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).
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.
我们旨在比较腰椎（L4/5 关节突）单侧后前向（UPA）松动术后主动膝关节伸展（AKE）和主动腰椎前屈（ALF）活动度的干预后时间进程变化。
招募 24 名无症状参与者（男性比例：0.58，年龄[平均值±标准差]：32±8 岁，体重指数 25.9±2.6 kg/m²）参加一项完全对照的交叉试验。在干预（L4/5 关节突松动）或对照之后，参与者立即进行 AKE 和 ALF 测试，这些测试在基线时也进行了。随后的测试在 5、10、15、20、25、30、45 和 60 分钟的间隔进行。
在对基线（平均 AKE：距完全伸展 37.2°，平均 ALF：14.37 cm）、性别和年龄进行调整后，UPA 腰椎松动对 AKE 有极有可能的中度影响（接近完全伸展 9.8°；±1.9），对 ALF 有有可能的中度影响（1.34 cm；±90%置信区间 0.43）。AKE 效应的大小在治疗后 20 分钟极有可能变小（5.3；±1.7），在治疗后 60 分钟可能变小/可能微不足道（2.1；±1.4）。对于 ALF，效应大小在治疗后 15 分钟极有可能变小（0.76；±0.25），在治疗后 25 分钟可能变小/可能微不足道（0.38；±0.18），在治疗后 60 分钟可能微不足道（0.26；±1.8）。
UPA 腰椎松动使腰椎活动度和腘绳肌伸展性适度增加，治疗后 10 - 20 分钟效果降低。临床医生在应用 UPA 腰椎松动时应考虑这些时间进程变化。临床试验注册：NCT03273400 证据水平：2b。
