title: The change in the diffusion of water in normal and degenerative lumbar intervertebral discs following joint mobilization compared to prone lying.
abstract: METHODS
  Prospective, repeated measures obtained under treatment and control conditions.
  
  
  OBJECTIVE
  The purposes of this study were to provide preliminary evidence regarding the immediate change in the diffusion of water in the nuclear region of normal and degenerative lumbar intervertebral discs (IVDs) following a single session of lumbar joint mobilization, and to compare these findings to the immediate change in the diffusion of water following a 10-minute session of prone lying.
  
  
  BACKGROUND
  There is conflicting evidence regarding the effectiveness and efficacy of lumbar joint mobilization. Increased knowledge of the physiologic effects of lumbar joint mobilization can lead to refinement of its clinical application.
  
  
  METHODS
  A total of 24 people (15 males and 9 females), ranging in age from 22 to 58 years, participated in this study. All subjects had a history of activity-limiting low back pain. Diffusion-weighted magnetic resonance images (DW-MRIs) were obtained immediately before and after a 10-minute session of lumbar joint mobilization. At least 1 month later, a second session was performed in which DW-MRIs were obtained immediately before and after a 10-minute session of prone lying.
  
  
  RESULTS
  Following lumbar joint mobilization, a significant increase (P = .002) in the mean values for diffusion of water was observed within degenerative IVDs at L5-S1 (22.2% increase; effect size, 0.97). Degenerative IVDs at L1-2 to L4-5 and normal IVDs at L1-2 to L5-S1 did not demonstrate a change in diffusion following joint mobilization. Prone lying was not associated with a change in diffusion for normal or degenerative IVDs.
  
  
  CONCLUSIONS
  The stimulus provided by lumbar joint mobilization may influence the diffusion of water in degenerative IVDs at L5-S1; however, these are preliminary findings and the relationship of these findings to pain and function needs further investigation.
authors.affiliation: Department of Exercise Science, School of Public Health, University of South Carolina, Columbia, SC 29208, USA. pbeattie@gwm.sc.edu
authors.forename: Paul F
authors.initials: PF
authors.lastname: Beattie
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Donley
authors.forename: Cathy F
authors.initials: CF
authors.lastname: Arnot
authors.forename: Ronald
authors.initials: R
authors.lastname: Miller
mesh_terms: D000328:Adult; D004058:Diffusion; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D007405:Intervertebral Disc Displacement / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation; D017116:Low Back Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation; D008159:Lumbar Vertebrae / Q000473:pathology*; D008297:Male; D020393:Manipulation, Spinal; D008875:Middle Aged; D016684:Prone Position; D014867:Water
chemical_list: D014867:Water