Effects of Mulligan SNAG in Chronic Nonspecific Low Back Pain

NCT07415538 | Completed

• 1 other identifier: SNAG
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this randomized controlled study was to compare the effects of Mulligan SNAG added to conventional physiotherapy with conventional physiotherapy alone and sham SNAG on pain, function, proprioception, and functional performance in individuals with chronic nonspecific low back pain.

Conditions

Nonspecific Chronic Low Back Pain; Pain; Manuel Therapy; Physical Therapy

Outcome Measures

Primary Outcomes (1)

• Pain Intensity (VAS)

  Pain intensity will be assessed using the Visual Analog Scale (VAS), a 10-cm horizontal line ranging from 0 (no pain) to 10 (worst imaginable pain). Participants will be asked to mark their perceived level of low back pain. Higher scores will indicate greater pain intensity.

  6 weeks

Secondary Outcomes (5)

• Lumbar Proprioception (Joint Position Sense Error)

  6 weeks

• Functional Performance (Five Times Sit-to-Stand Test)

  6 weeks

• Functional Disability (ODI)

  6 weeks

• Kinesiophobia (Tampa Scale of Kinesiophobia)

  6 weeks

• Global Rating of Change (GRC)

  At week 6 of the intervention

Study Arms (3)

Conventional Physiotherapy

EXPERIMENTAL

Other: Conventional Physiotherap

Conventional Physiotherapy + Mulligan SNAG

EXPERIMENTAL

Other: Conventional Physiotherapy + Mulligan SNAG

Conventional Physiotherapy + Sham SNAG

SHAM COMPARATOR

Other: Conventional Physiotherapy + Sham SNAG

Interventions

Conventional Physiotherapy + Mulligan SNAG OTHER

Participants in this arm received the same conventional physiotherapy program as the control group, combined with Mulligan Sustained Natural Apophyseal Glide (SNAG) techniques applied to the lumbar spine. SNAG techniques were performed by a physiotherapist during active pain-free movements, three times per week for six weeks.

Conventional Physiotherapy + Mulligan SNAG

Conventional Physiotherap OTHER

Participants in this arm received a standardized conventional physiotherapy program consisting of electrotherapy, thermal modalities, stretching exercises, and core stabilization exercises. The program was administered three times per week for six weeks.

Conventional Physiotherapy

Conventional Physiotherapy + Sham SNAG OTHER

Participants in this arm received the standardized conventional physiotherapy program combined with sham SNAG applications. The sham procedure mimicked the positioning and therapist-patient interaction of the SNAG technique but without the application of therapeutic glide force. Interventions were administered three times per week for six weeks.

Conventional Physiotherapy + Sham SNAG

Eligibility Criteria

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

You may qualify if:

• Adults aged between 18 and 65 years
• Presence of chronic nonspecific low back pain lasting for at least 6 months
• No signs or symptoms of radicular pain or progressive neurological deficit
• No history of lumbar spine surgery
• No manual therapy, spinal injection, or structured physiotherapy program for low back pain within the last 3 months
• Ability to participate in a physiotherapy and exercise program
• Willingness to participate in the study and provision of written informed consent

You may not qualify if:

• Specific causes of low back pain (e.g., fracture, tumor, infection, inflammatory spinal disorders)
• Presence of radiculopathy or severe neurological impairment
• History of spinal surgery
• Pregnancy
• Severe balance, vestibular, or neurological disorders that may interfere with proprioception testing
• Any medical condition contraindicating physical therapy or manual therapy
• Participation in another clinical trial or receiving concurrent treatment for low back pain during the intervention period

Sponsors & Collaborators

• Biruni University: lead

Study Sites (1)

Biruni University

Istanbul, Zeytinburnu, 34015, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain

Condition Hierarchy (Ancestors)

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

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: February 10, 2026
• First Posted: February 17, 2026
• Study Start: January 5, 2026
• Primary Completion: February 13, 2026
• Study Completion: February 20, 2026
• Last Updated: March 2, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)