title: An investigation into the effects of applying a lumbar Maitland mobilisation at different frequencies on sympathetic nervous system activity levels in the lower limb.
abstract: BACKGROUND
  Oscillatory Maitland mobilisations are commonly used in the management of lower back pain with research suggesting that mobilisations at 2 Hz may excite the sympathetic nervous system (SNS) more than sustained pressure glides or 0.5 Hz oscillatory mobilisations.
  
  
  OBJECTIVE
  Investigate the effects of increasing the oscillation frequency greater than 2 Hz.
  
  
  METHODS
  A double-blind, placebo-controlled, independent group experimental design.
  
  
  METHODS
  Sixty healthy male volunteers were randomly allocated to one of four groups; a control group (no contact), placebo group (sustained static pressure to L4 vertebra), and two intervention groups receiving a centrally applied postero-anterior mobilisation applied at either 2 Hz or 3 Hz for three 1-min periods. SNS activity was recorded by a blinded data collector by continuous skin conductance (SC) activity levels in the feet using a Biopac MP35 electrodermal amplifier. Participants were blinded to their group allocation which was further validated by a post-experiment questionnaire (p > 0.05).
  
  
  RESULTS
  The magnitude of sympathoexcitatory response was greatest for the 3 Hz mobilisation (20%) compared with the 2 Hz mobilisation (12%), placebo (-1%) and control conditions (3%). Only the 3 Hz group demonstrated statistical significance when compared to placebo intervention (p = 0.002), and the control group (p = 0.02).
  
  
  CONCLUSIONS
  SC changes reflect those of previous studies using lumbar mobilisations at 2 Hz, however the 3 Hz group was found to have a greater magnitude of effect worthy of consideration within research and clinical settings. These findings provide preliminary evidence to support the use of 3 Hz oscillatory mobilisations to affect a greater magnitude of SNS activity than those previously reported (0.5, 1.5 and 2 Hz).
authors.affiliation: Defence Primary Healthcare, Army Training Centre, Pirbright GU24 0QQ, UK. Electronic address: Victoria@piekarz.co.uk.
authors.forename: Victoria
authors.initials: V
authors.lastname: Piekarz
authors.affiliation: Coventry University, Faculty of Health and Life Sciences, Department of Applied Sciences and Health, Priory Street, Coventry CV1 5FB, UK. Electronic address: hsx472@coventry.ac.uk.
authors.forename: Jo
authors.initials: J
authors.lastname: Perry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology* / Q000628:therapy*; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods*; D008875:Middle Aged; D011795:Surveys and Questionnaires; D013564:Sympathetic Nervous System / Q000503:physiopathology
keywords: Joint mobilisations; Lumbar spine; Sympathetic nervous system