Effectiveness of Mulligan bent leg raise and instrument-assisted soft tissue mobilization techniques on hamstring flexibility and functional disability in non-specific low back pain: a randomized controlled trial

Arul Pragassame Sivaraman; Bala Murali Krishnaraj; Paruthirajan Subash; Nijidha Manshi; Ahalya Sreekumaran; Vignesh Srinivasan

doi:10.18203/2320-6012.ijrms20263105

Authors

Arul Pragassame Sivaraman Department of Physical Medicine and Rehabilitation (Physiotherapy), Government Medical College and Hospital, (Affiliated to the Tamil Nadu Dr. MGR Medical University) Annamalai Nagar, Cuddalore District, Tamil Nadu, India
Bala Murali Krishnaraj School of Physiotherapy, Vinayaka Missions Research Foundation, Kirumampakkam, Puducherry, Tamil Nadu, India
Paruthirajan Subash School of Physiotherapy, Vinayaka Missions Research Foundation, Kirumampakkam, Puducherry, Tamil Nadu, India
Nijidha Manshi Department of Physiotherapy, Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Science (SIMATS), Chennai, Tamil Nadu, India
Ahalya Sreekumaran
Vignesh Srinivasan Department of Physiotherapy, Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Science (SIMATS), Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20263105

Keywords:

Functional disability, Hamstring tightness, Instrument-assisted soft tissue mobilization, Non-specific low back pain, Mulligan bent leg raise

Abstract

Background: Non-specific low back pain or NSLBP, a musculoskeletal condition that results in pain, decreased flexibility, and functional impairment, is commonly associated with hamstring tightness. Manual therapy techniques like Mulligan Bent Leg Raise (BLR) and IASTM, or Instrument-Assisted Soft Tissue Mobilization are frequently used to improve hamstring flexibility and alleviate discomfort. However, there isn't much information comparing their effectiveness in individuals with NSLBP.

Methods: A randomized comparison study was conducted with forty male volunteers, ages 18 to 40, who had tight hamstrings with NSLBP. Each of the two randomly allocated groups, Group A (Mulligan BLR) and Group B (IASTM), had 20 participants. Interventions were administered three times a week for two weeks. The outcomes were evaluated using the Numerical Pain Rating Scale (NPRS), the Quebec Back Pain Disability Scale (QBPDS), and Active Knee Extension Test (AKET).

Results: Both groups' functional impairment, hamstring flexibility, and pain significantly improved after treatment (p=0.001). Between-group analysis revealed that the Mulligan BLR group had better reductions in NPRS scores (mean difference=2.00), better improvements in left and right AKET scores (mean differences=10.45° and 10.55°, respectively), and a greater reduction in QBPDS scores (mean difference=12.90) (p=0.001).

Conclusions: Both Mulligan BLR and IASTM were effective in reducing pain, improving hamstring flexibility, and reducing functional impairment. However, Mulligan BLR demonstrated significantly better outcomes on all end measures and may be a more effective treatment for hamstring tightness associated with NSLBP.

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