title: Flexion mobilizations with movement techniques: the immediate effects on range of movement and pain in subjects with low back pain.
abstract: OBJECTIVE
  This study investigates the immediate effects of flexion mobilizations with movement techniques (MWMs) on spinal range of movement in individuals with low back pain and also their impact on pain. A preliminary attempt has been made to describe the clinical profiles of subjects who were thought to benefit from MWMs.
  
  
  METHODS
  A small-scale explanatory study was conducted using a crossover design, placebo-controlled, with subjects and assessors blinded. After assessment by physiotherapists, 26 subjects with low back pain with pain on lumbar flexion, thought to be appropriate for treatment with MWMs, participated. Subjects received an MWM intervention and a placebo intervention in a randomized order. Lumbar spinal flexion and extension and pain during flexion were recorded immediately before and after each intervention, using double inclinometry and visual analogue scales.
  
  
  RESULTS
  Mean spinal range of movement increased significantly with the MWM intervention, as compared with the placebo (true flexion: MWMs 49.2 degrees [SD 16.4], placebo 45.3 degrees [SD 14.1], P = .005; total flexion: MWMs 76.7 degrees [SD 22.4], placebo 69.7 degrees [SD 21.5], P = .005). Mean pain scores did not change.
  
  
  CONCLUSIONS
  The MWMs produced statistically significant, but small, immediate spinal mobility increases but no pain reduction when compared with placebo. By introducing clinical judgment into the subject selection process for the trial, 19 (73%) of 26 subjects benefited from MWMs techniques in terms of range of movement and/or pain intensity, whereas 9 (35%) subjects showed such changes with the placebo intervention.
authors.affiliation: Spinal Physiotherapy Specialist/Research Physiotherapist, Haywood Hospital/ Primary Care Sciences Research Centre, Keele University, UK. k.konstantinou@cphc.keele.ac.uk
authors.forename: Kika
authors.initials: K
authors.lastname: Konstantinou
authors.forename: Nadine
authors.initials: N
authors.lastname: Foster
authors.forename: Alison
authors.initials: A
authors.lastname: Rushton
authors.forename: David
authors.initials: D
authors.lastname: Baxter
authors.forename: Christine
authors.initials: C
authors.lastname: Wright
authors.forename: Alan
authors.initials: A
authors.lastname: Breen
mesh_terms: D000293:Adolescent; D000328:Adult; D018592:Cross-Over Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000145:classification / Q000628:therapy*; D008297:Male; D026882:Manipulation, Chiropractic / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular; D016896:Treatment Outcome