Mulligan Mobilization Techniques for Non-Specific Low Back Pain

NCT07181395 | Not Yet Recruiting

• 2 other identifiers: GU-ETHICS-2025-08-863GU-Ethics-08/863
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to compare the effectiveness of two different Mulligan mobilization techniques in patients with non-specific low back pain. A total of 30 adults with chronic low back pain will be randomly assigned to three groups: (1) conventional physiotherapy plus hip internal rotation Mulligan mobilization, (2) conventional physiotherapy plus straight leg raise Mulligan mobilization, or (3) conventional physiotherapy only. The interventions will be applied twice a week for four weeks. The main outcomes are pain intensity (measured by Visual Analog Scale) and lumbar range of motion. Secondary outcomes include disability level (Oswestry Disability Index) and back awareness (Fremantle Back Awareness Questionnaire). The study will help determine whether Mulligan techniques provide additional benefits beyond conventional physiotherapy in reducing pain and improving function in people with non-specific low back pain.

Conditions

Non-specific Low Back Pain (NSLBP)

Keywords

Mulligan Mobilization, Hip Internal Rotation, Straight Leg Raise, Physiotherapy, Manual Therapy, Low Back Pain

Outcome Measures

Primary Outcomes (2)

• Pain Intensity (Visual Analog Scale, VAS)

  Pain intensity will be assessed using the Visual Analog Scale (VAS), a 100 mm horizontal line ranging from "no pain" to "worst pain imaginable." Participants will mark their pain level, and the distance in millimeters will be recorded.

  Baseline (week 0) and post-treatment (week 4).

• Lumbar Range of Motion (ROM)

  Lumbar spinal range of motion will be measured using a goniometer. Participants will perform active forward flexion, and the angle of motion will be recorded in degrees.

  Baseline (week 0) and post-treatment (week 4).

Secondary Outcomes (2)

• Disability Level (Oswestry Disability Index - ODI)

  Baseline (week 0) and post-treatment (week 4)

• Back Awareness (Fremantle Back Awareness Questionnaire - FreBAQ)

  Baseline (week 0) and post-treatment (week 4).

Study Arms (3)

Conventional Physiotherapy + Hip Internal Rotation Mulligan Mobilization

EXPERIMENTAL

Participants will receive conventional physiotherapy combined with Mulligan mobilization applied to hip internal rotation. The mobilization will be performed with a mobilization belt, 3 sets of 10 repetitions, twice weekly for 4 weeks.

Behavioral: Hip Internal Rotation Mulligan Mobilization; Behavioral: Conventional Physiotherapy

Conventional Physiotherapy + Straight Leg Raise Mulligan Mobilization

EXPERIMENTAL

Participants will receive conventional physiotherapy combined with Mulligan mobilization applied to straight leg raise under traction. The mobilization will be performed in 3 sets of 10 repetitions (15-20 seconds hold), twice weekly for 4 weeks.

Behavioral: Straight Leg Raise Mulligan Mobilization; Behavioral: Conventional Physiotherapy

Conventional Physiotherapy Only

ACTIVE COMPARATOR

Participants will receive conventional physiotherapy only, including transcutaneous electrical nerve stimulation (20 minutes), massage, stretching and strengthening exercises for lumbar muscles, postural training, and patient education. Treatment will be delivered twice weekly for 4 weeks.

Behavioral: Conventional Physiotherapy

Interventions

Hip Internal Rotation Mulligan Mobilization BEHAVIORAL

Mulligan mobilization applied to hip internal rotation using a mobilization belt. Performed in 3 sets of 10 repetitions, twice weekly for 4 weeks, in addition to conventional physiotherapy.

Also known as: Mulligan Hip IR Mobilization

Conventional Physiotherapy + Hip Internal Rotation Mulligan Mobilization

Straight Leg Raise Mulligan Mobilization BEHAVIORAL

Mulligan mobilization applied to straight leg raise under manual traction. Performed in 3 sets of 10 repetitions (15-20 seconds hold), twice weekly for 4 weeks, in addition to conventional physiotherapy.

Also known as: Mulligan SLR Mobilization

Conventional Physiotherapy + Straight Leg Raise Mulligan Mobilization

Conventional Physiotherapy BEHAVIORAL

Conventional physiotherapy including transcutaneous electrical nerve stimulation (20 minutes), massage, lumbar stretching and strengthening exercises, postural training, and patient education. Delivered twice weekly for 4 weeks.

Also known as: Standard Physiotherapy

Conventional Physiotherapy + Hip Internal Rotation Mulligan Mobilization; Conventional Physiotherapy + Straight Leg Raise Mulligan Mobilization; Conventional Physiotherapy Only

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥ 18 years
• Diagnosed with non-specific low back pain (NSLBP) for at least 3 months
• Able to walk independently
• Willing to participate and provide written informed consent

You may not qualify if:

• Specific causes of low back pain (e.g., disc herniation, spinal stenosis, tumor)
• Presence of neurological deficits or radiculopathy
• Hip joint pathologies limiting mobility (e.g., osteoarthritis)
• History of lumbar surgery in the last 6 months
• Diagnosed osteoporosis or osteopenia
• Contraindications for Mulligan mobilization
• Severe physical or cognitive impairments preventing participation
• Participation in other physiotherapy or manual therapy treatments during the study period

Sponsors & Collaborators

• Gazi University: lead

Study Sites (1)

Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation

Ankara, Ankara, 06500, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Low Back Pain

Condition Hierarchy (Ancestors)

Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Central Study Contacts

Yusuf Kaan KAYA

CONTACT

+90-505-013-81-65; fzt.yusufkaankaya@gmail.com

Rukiye ALTUNBAS

CONTACT

+90-545-227-27-95; rukiskacar@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: This is a triple-blind study. Participants, outcome assessors, and investigators performing data analysis are blinded to group allocation. Only physiotherapists delivering the interventions are not blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor Dr.

Study Record Dates

• First Submitted: September 12, 2025
• First Posted: September 18, 2025
• Study Start: September 7, 2025
• Primary Completion: October 7, 2025
• Study Completion: December 1, 2025
• Last Updated: September 18, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)