Zeliha Candan ALGUN, Gülay ARAS BAYRAM, Bilge Büşra KOMŞUOĞLU

Kronik bel ağrısında Mulligan Bent Leg Raise ve Sustained Natural Apophyseal Glides tekniklerinin karşılaştırılması

Amaç: Çalışmada Mulligan Bent Leg Raise (BLR) ve Sustained Natural Apophyseal Glides (SNAGS) tekniklerinin kronik bel ağrısındaki etkinliğinin karşılaştırılması amaçlandı.Yöntem: Çalışmaya yaşları 25-55 arasında, spesifik olmayan bel ağrısı şikâyeti en az 3 aydır devam eden 45 birey alındı. Hastalar randomize bir şekilde, Kontrol grubu (n=15), Mulligan BLR grubu (n=15) ve Mulligan SNAGS grubu (n=15) olarak 3’e ayrıldı. Her 3 gruba uygulanan klasik elektroterapi yöntemlerine ilave olarak BLR grubuna Mulligan BLR tekniği, SNAGS grubuna Mulligan SNAGS tekniği uygulandı. Hastaların dinlenme ve hareket durumundaki ağrısı görsel analog skala ile, lumbar bölge eklem hareket açıklığı inklinometre ile, esneklik değerlendirmesi Schober ve parmak-zemin testi ile ve fonksiyonel düzeyleri Oswestry Bel Ağrısı Anketi ile tedavi öncesi ve sonrasında değerlendirildi.Bulgular: Tedavi sonrasında tüm gruplarda istirahat ve hareket esnasında ağrı şiddetlerinde ve Schober testi sonuçlarında anlamlı fark belirlendi (p<0,05). SNAGS grubundaki olguların eklem hareket açıklıklarındaki artış diğer gruplara göre anlamlı olarak daha yüksek bulundu (p<0,05). SNAGS grubundaki parmak zemin testindeki değişimin diğer gruplara göre anlamlı olarak daha yüksek olduğu belirlendi (p<0,05). Oswestry skalası sonuçları karşılaştırıldığında, BLR grubundaki değişim diğer gruplara kıyasla anlamlı olarak daha yüksekti (p<0,05).Sonuç: Mulligan mobilizasyon teknikleri ağrı azalmasında, eklem hareket açıklığı, esneklik ve fonksiyonelliğin artmasında etkili bulundu. Mulligan mobilizasyon grupları karşılaştırıldığında BLR grubunun fonksiyonelliği arttırmada SNAGS grubuna göre daha etkili olduğu, SNAGS grubunun eklem hareket açıklığı ve esnekliği arttırmada BLR grubuna göre daha etkili olduğu belirlendi.

Anahtar Kelimeler:

Kronik bel ağrısı, Mulligan Mobilizasyonu, Bent Leg Raise, Sustained Natural Apophyseal Glides

Comparison of Mulligan Bent Leg Raise and Sustained Natural Apophyseal Glides techniques in chronic low back pain

Purpose: The aim of this study was to compare the effectiveness of Mulligan Bent Leg Raise (BLR) and Sustained Natural Apophyseal Glides (SNAGS) techniques in chronic low back pain.Methods: Forty-five individuals between the ages of 25-55 who had nonspecific low back pain at least 3 months were included in the study. The patients were randomly divided into 3 groups as Control group (n= 15), Mulligan BLR group (n= 15) and Mulligan SNAGS group (n= 15). In addition to the classical electrotherapy methods applied to all 3 groups; Mulligan BLR technique was applied to BLR group and Mulligan SNAGS technique was applied to SNAGS group. Patients’ pain at rest and in motion was evaluated with visual analog scale, lumbar range of motion with inclinometer, flexibility assessment with Schober and finger-floor test, and functional levels with Oswestry Low Back Pain Questionnaire before and after treatment.Results: After treatment, a significant difference was determined in pain intensity during rest and movement and in the results of Schober test in all groups (p<0.001). The increase in range of motion of the patients in the SNAGS group was found to be significantly higher than the other groups (p<0.05). It was determined that the change in finger ground test in the SNAGS group was significantly higher than the other groups (p<0.05). When Oswestry results were compared, the change in the BLR group was significantly higher than the other groups (p <0.05).Conclusion: Mulligan mobilization techniques were found effective in reducing pain, increasing range of motion, flexibility, and functionality. When the Mulligan mobilization groups were compared, it was determined that the BLR group was more effective in enhancing functionality than the SNAGS group, and the SNAGS group was more effective in enhancing joint range of motion and flexibility than the BLR group.

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