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Trial registered on ANZCTR
Registration number
ACTRN12615001298505
Ethics application status
Approved
Date submitted
26/08/2015
Date registered
27/11/2015
Date last updated
24/01/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of Mulligan`s lumbar “SNAG” on chronic non-specific low back pain
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Scientific title
Effect of Mulligan`s lumbar "SNAG" on proprioception, pain, range of Motion and functional level in chronic non-specific low back pain patients
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Secondary ID [1]
287356
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NIL
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Universal Trial Number (UTN)
U1111-1173-6848
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
chronic non-specific low back pain
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Condition category
Condition code
Physical Medicine / Rehabilitation
296298
296298
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0
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Physiotherapy
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Musculoskeletal
296941
296941
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
1- standard physiotherapy (including infrared heating of the low back for 15 minutes, stretching exercises for back, hamstrings, iliopsoas muscles - 3 repetitions X 30 seconds hold X 30 seconds rest , strengthening exercises for abdominal muscles 1 set X 10 repetitions X 5 seconds hold.
- frequency of standard treatment sessions: 3 x 40 minutes per week for 4 weeks.
- (estimated total session duration is: 40 mins,
2- "SNAG" Mulligan technique applied from setting position on the L4, and L5 spinous processes in a cephalic direction for 3 sets X 5 repetitions (for about 10 mins / session . 3 session /week for 4 weeks). SNAG technique will be applied by physiotherapist.
- SNAG will be applied at the end of the session for the study group only (the total study group session time will be 50 mins. (the 10 minutes lack in control group session time will be filled with examination and history talking to achieve equality in time involved in patients treatment and caring)
Note: first program will be introduced to the control group, the first and second program will be both introduced to the experimental (study) group
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Intervention code [1]
292694
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Treatment: Other
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Intervention code [2]
292695
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Rehabilitation
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Comparator / control treatment
standard physiotherapy treatment:including infrared heating of the low back for 15 minutes, stretching exercises for back, hamstrings, iliopsoas muscles - 3 repetitions X 30 seconds hold X 30 seconds rest , strengthening exercises for abdominal muscles 1 set X 10 repetitions X 5 seconds hold.
total session time is 40 mins (plus 10 minutes for history taking and talking with the patient and preparation to assure spending the same time in both control and study groups patients)
3 sessions per week for 4 weeks.
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Control group
Active
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Outcomes
Primary outcome [1]
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lumbar spine proprioception in the form of measuring the repositioning accuracy
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Assessment method [1]
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Timepoint [1]
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before and immediately after the end of one month of treatment application
measured by Biodex System 3 Pro Isokinetic Dynamometer (Biodex Medical Inc., Shirley, New York, USA).
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Secondary outcome [1]
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pain level measured by non-numerical 100mm VAS
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Assessment method [1]
317013
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Timepoint [1]
317013
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before and immediately after the end of the one month of treatment application
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Secondary outcome [2]
317014
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range of movement of the lumbar spine : flexion and extension
will be measured by inclinometer
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Assessment method [2]
317014
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Timepoint [2]
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immediately after the end of the last session of the one month treatment application (after the 12th session)
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Secondary outcome [3]
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functional level
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Assessment method [3]
317015
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Timepoint [3]
317015
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Oswestry Disability Index
before and immediately after the end of one month of the treatment application
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Eligibility
Key inclusion criteria
1- patients diagnosed (by physician) with chronic non-specific low back pain.
2- signs and symptoms lasts more than 3 months.
3- patient must be able to assume at least more than 30 degrees of trunk flexion to be able to perform the task required for repositioning accuracy on the isokinetic machine.
4- patients with moderate Oswestry Disability Index results only will be included.
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Minimum age
17
Years
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Maximum age
60
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1- Any low back pain due to a definite cause as; arthritis, degenerative joint diseases, disc lesion, inflammation and facet joint disease.
2- Patients with a history of head trauma or other neurological manifestations.
3- Obese patients with body mass index (BMI) above 25, and pregnant females.
4- Any patients having the common contraindications for manual therapy as joint hyperlaxity, instability, acute infection.
5-Severe disabling LBP.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
the included subjects will be selected systematically from a list of the patients attending the faculty of physical therapy out-patient clinic, Cairo, Egypt.
after applying the initial assessment and signing the informed consent, each subject will be asked to pick a closed envelop containing a numbered card. this number will determines if the subject will be in the control or the study groups
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
the number of the sample will be based on the results of a pilot study of five patients before starting the actual study. this is because there are no previous study on the effects of the SNAG on lumbar proprioception
power: 80%
significance level: .95%
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/12/2015
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Date of last participant enrolment
Anticipated
30/03/2016
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Actual
29/12/2015
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Date of last data collection
Anticipated
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Actual
30/01/2016
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Sample size
Target
40
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Accrual to date
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Final
42
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Recruitment outside Australia
Country [1]
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Egypt
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State/province [1]
7296
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Cairo
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Hisham Mohamed AbdelRaheem Hussien (the main researcher)
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Address [1]
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Egypt - AlGiza - 6th Ahmed Elsayat street - Faculty of Physical Therapy- Cairo University.
postal code 12611
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Country [1]
291915
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Egypt
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Primary sponsor type
Individual
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Name
Hisham Mohamed AbdelRaheem Hussien
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Address
Egypt - AlGiza - 6th Ahmed Elsayat street - Faculty of Physical Therapy- Cairo University.
postal code 12611
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Country
Egypt
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
290585
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Ethical comitte of faculty of physical therapy cairo university
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Ethics committee address [1]
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Egypt , Al-Giza, 6th Ahmad Elzyat st.
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Ethics committee country [1]
293421
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Egypt
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Date submitted for ethics approval [1]
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17/04/2014
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Approval date [1]
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20/04/2015
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Ethics approval number [1]
293421
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P.T.REC/012/00861
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Summary
Brief summary
this study has the aim of revealing the effect of Mulligan "SNAG" technique on low back priprioception, pain level, ROM, and functional level in patients suffering from chronic non-specific low back pain. the primary purpose of this study is to investigate if this technique has an effect on the improvement of lumbar spine proprioception which was proved to be affected in study patient population and may be a cause of their condition. this study try to investigate a new possible mechanism (effect on proprioception) that can explain the efficacy of SNAG technique reported by previous studies. this study is considered one of the few available study that tried to think outside the box regarding the effects of snag as one of the mulligan techniques as the majority of the previous studies adopted only the mechanical explanation mentioned by Mulligan himself.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Mr Hisham Mohamed Abdel_raheem Hussien
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Address
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Faculty of Physical Therapy, Cairo University, Basic Science Department
Egypt - Al-Giza - Bein Elsarayat - 6th Ahmad Elzayat street.
post code : 12211
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Country
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Egypt
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Phone
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+2 01020936303
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Ebrahim Mostafa
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Address
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Faculty of Physical Therapy, Cairo University, basic Science Department,
Egypt - Al-Giza -Bein Elsarayat - 6th Ahmad Elzyat st.
post code : 12211
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Country
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Egypt
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Phone
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+2 01227022334
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Omaima Kattabei
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Address
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Faculty of Physical Therapy, Cairo University, basic Science Department,
Egypt - Al-Giza -Bein elsarayat- 6th Ahmad Elzyat st.
post code : 12211
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Country
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Egypt
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Phone
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+20 1222194545
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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