Comparing the effectiveness of lumbar contralateral rotation to unilateral posteroanterior mobilization in the treatment of unilateral low back pain: A singleblinded randomized placebo-controlled trial

Background: The use of manipulative therapy to treat patients with non-specific low back pain (NSLBP) has been proposed based on the patient’s clinical presentation. Objective: To investigate the effects of the lumbar contralateral rotation and unilateral posteroanterior (uniPA) mobilizations on LBP intensity and lumbar range of motion (LROM) in the treatment of unilateral NSLBP patients. Materials and methods: A single-blinded randomized placebo-controlled trial was conducted. Sixty of unilateral NSLBP were randomly allocated using concealed opaque envelopes into 2 groups either; rotation or uniPA groups and collected the pre-intervention data (O1). All participants were received a detuned short-wave diathermy technique and collected the after-placebo data (O2). Then, the therapist treated the participants according to their group allocation and collected the aftermobilization data (O3). Lastly, the participants were recalled within 2 days to collect the follow-up data (O4). Two-way mixed repeated analysis of variance and Paired t-test was used to investigate the immediate and latent effects, and placebo and flare-up effects, respectively. Results: The result showed no placebo effect (p>0.05). There was no difference between groups and time effects (both immediate and latent effects) (p>0.05). However, there were statistically significant differences within group of immediate and latent effects on pain reduction and LROM improvement (p<0.001). Moreover, results noted on the flare-up on pain alleviation at rest in the uniPA group (p<0.05). Conclusion: These findings partially support the recommendation of using mobilization techniques in the treatment of NSLBP patients with unilateral symptoms.