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Effects of a Single Session of Posterior-to-Anterior Spinal Mobilization and Press-up Exercise on Pain Response and Lumbar Spine Extension in People With Nonspecific Low Back Pain

CM Powers, PT, PhD, is Associate Professor, Division of Biokinesiology and Physical Therapy at the School of Dentistry, University of Southern California, 1540 E Alcazar St, CHP-155, Los Angeles, CA 90089-9006 (USA)
GJ Beneck, PT, MS, OCS, is a PhD student, Division of Biokinesiology and Physical Therapy at the School of Dentistry, University of Southern California, and Lecturer, Department of Physical Therapy, California State University at Long Beach, Long Beach, Calif
K Kulig, PT, PhD, is Associate Professor of Clinical Physical Therapy, Division of Biokinesiology and Physical Therapy at the School of Dentistry, University of Southern California
RF Landel, PT, DPT, OCS, CSCS, is Associate Professor of Clinical Physical Therapy, Division of Biokinesiology and Physical Therapy at the School of Dentistry, University of Southern California
M Fredericson, MD, is Associate Professor, Department of Orthopaedic Surgery, Division of Sports Medicine, Stanford University, Stanford, Calif, and Director of Stanford Physical Medicine and Rehabilitation Clinics

Address all correspondence to Dr Powers at: powers{at}usc.edu

Background and Purpose: Posterior-to-anterior (PA) mobilization and press-up exercises are common physical therapy interventions used to treat low back pain. The purpose of this study was to examine the immediate effects of PA mobilization and a press-up exercise on pain with standing extension and lumbar extension in people with nonspecific low back pain.

Subjects: The study participants were 30 adults (19 women and 11 men) who were 18 to 45 years of age and had a diagnosis of nonspecific low back pain.

Methods: Lumbar segmental extension during a press-up maneuver was measured by dynamic magnetic resonance imaging prior to and immediately following a single session of either PA spinal mobilization or a press-up exercise. Pain scores before and after intervention were recorded with a visual analog scale. Differences between the treatment groups in pain and total lumbar extension were compared over time by use of a 2-way analysis of variance.

Results: Following both interventions, there was a significant reduction in the average pain scores for both groups (significant main effect for time, no interaction). Similarly, total lumbar extension significantly increased in both the PA mobilization group and the press-up group (significant main effect for time, no interaction). No significant differences between the 2 interventions in pain or lumbar extension were found.

Discussion and Conclusion: The findings of this study support the use of PA mobilization and a press-up exercise for improving lumbar extension in people with nonspecific low back pain. Although statistically significant within-group changes in pain were detected, the clinical meaningfulness of these changes is questionable.