NCT07364721

Maitland Mobilization vs. McKenzie Press-Up in Chronic LBP

Comparative Efficacy of Maitland Mobilization vs. McKenzie Press-Up in Chronic Low Back Pain: A Randomized Trial

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 50 (actual)
• Sponsor: Palestine Ahliya University · Academic / Other
• Sex: All
• Age: 18 Years – 50 Years
• Healthy volunteers: Not accepted

Summary

ABSTRACT Objective:This study aimed to compare the efficacy of central posteroanterior (PA) Maitland mobilization with myofascial release (MFR) and McKenzie prone press-up (PPU) exercise with MFR in the treatment of adult patients with chronic non-specific low back pain (CNLBP). Materials and Methods:A randomized controlled trial was conducted at Salhab Center and Al Shifa's Specialized Complex in Bethlehem between January 2023 and May 2024. The study included 50 adult patients (aged 18-50) with CNLBP of more than 3 months but less than 2 years' duration, referred by an orthopedic specialist at Beit Sahour Medical Center. Participants were randomly assigned to two groups: one received central PA Maitland mobilization with MFR, and the other received McKenzie PPU exercise with MFR. Pain intensity, functional impairment, and fear-avoidance beliefs were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Fear-Avoidance Beliefs Questionnaire (FABQ). Each patient underwent three sessions per week for four weeks.

Detailed description

This randomized controlled trial evaluated physiotherapy interventions in adults with chronic non-specific low back pain (CNLBP). The study was conducted at Salhab Center for Physiotherapy and Al Shifa's Specialized Complex in Bethlehem City between December 2023 and May 2024. These centers were selected for their accessibility and coordinated referral system. Participants were referred from orthopedic assessment to physiotherapy, where baseline evaluations were completed prior to randomization. Random allocation to intervention groups was performed using a concealed allocation method. Physiotherapy interventions were delivered by licensed physiotherapists according to standardized treatment protocols to ensure consistency. Treatment sessions consisted of structured therapeutic exercises and manual therapy techniques, with progression individualized based on patient response. Outcome data were collected at baseline and at the end of the intervention period using validated assessment tools. Participant adherence and adverse events were monitored throughout the study. All procedures were conducted in accordance with ethical standards, and informed consent was obtained from all participants.

Conditions

• Back Pain Lower Back

Interventions

Type	Name	Description
OTHER	Group B (McKenzie PPU exercise with MFR)	Patient position: The patient assumes a prone position. Therapist position: The therapist stands beside the patient and provides verbal instruction. Direction: Patients were being instructed to perform PPU exercise by using their upper limbs to push their upper body up into spinal extension while the pelvis remained on the treatment table. The patient is trained to extend the lumbar spine to the maximum pain-free range. Frequency: Ten repetitions for three sets with a 30-second break between each set for almost 10 minutes
OTHER	Central Posteroanterior Mobilization	According to Maitland's concept, mobilization technique including passive accessory intervertebral movement was applied to cause movement in the stiff vertebral segment without the active involvement of the muscles \[44\]. Central PA mobilization technique is a cornerstone of Maitland vertebral mobilization \[38\]. It can be achieved by passive force onto a vertebral segment in the PA direction \[44\]. Patient position: When applying this technique, the patient assumes a relaxed and comfortable prone position, with the arms positioned alongside the body \[23, 24\]. investigator position: The investigator stands close to the patient, with their sternum perpendicular to the selected lumbar spinous process \[23\]. The investigator uses the ulnar surface of the hand (pisiform) over the selected spinous process in the lumbar spine, another hand taken was placed above the first hand to reinforce, and the elbow should slightly bent with forearm in neutral between supination \& pronation.
OTHER	McKenzie PPU exercise with MFR	Patient position: The patient assumes a prone position. investigator position: The investigator stands beside the patient and provides verbal instruction. Direction: Patients were being instructed to perform PPU exercise by using their upper limbs to push their upper body up into spinal extension while the pelvis remained on the treatment table. The patient is trained to extend the lumbar spine to the maximum pain-free range. Frequency: Ten repetitions for three sets with a 30-second break between each set for almost 10 minutes

Timeline

• Start date: 2023-12-01
• Primary completion: 2024-04-01
• Completion: 2024-05-01
• First posted: 2026-01-23
• Last updated: 2026-01-23

Locations

1 site across 1 country: Palestinian Territories