Effects of a Single Session of Posterior-to-Anterior Spinal Mobilization and Press-up Exercise on Pain Response and Lumbar Spine Extension in People With Nonspecific Low Back Pain

Abstract

Background and Purpose Posterior-to-anterior (PA) mobilization and press-up exercises are common physical therapy interventions used to treat low back pain. The purpose of this study was to examine the immediate effects of PA mobilization and a press-up exercise on pain with standing extension and lumbar extension in people with nonspecific low back pain. Subjects The study participants were 30 adults (19 women and 11 men) who were 18 to 45 years of age and had a diagnosis of nonspecific low back pain. Methods Lumbar segmental extension during a press-up maneuver was measured by dynamic magnetic resonance imaging prior to and immediately following a single session of either PA spinal mobilization or a press-up exercise. Pain scores before and after intervention were recorded with a visual analog scale. Differences between the treatment groups in pain and total lumbar extension were compared over time by use of a 2-way analysis of variance. Results Following both interventions, there was a significant reduction in the average pain scores for both groups (significant main effect for time, no interaction). Similarly, total lumbar extension significantly increased in both the PA mobilization group and the press-up group (significant main effect for time, no interaction). No significant differences between the 2 interventions in pain or lumbar extension were found. Discussion and Conclusion The findings of this study support the use of PA mobilization and a press-up exercise for improving lumbar extension in people with nonspecific low back pain. Although statistically significant within-group changes in pain were detected, the clinical meaningfulness of these changes is questionable.