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. 2012 Feb;20(1):35-42.
doi: 10.1179/2042618611Y.0000000015.

Effect of slump stretching versus lumbar mobilization with exercise in subjects with non-radicular low back pain: a randomized clinical trial

Amit Vinayak Nagrale  1 , Shubhangi Pandurang Patil, Rita Amarchand Gandhi, Ken Learman
Affiliations

Effect of slump stretching versus lumbar mobilization with exercise in subjects with non-radicular low back pain: a randomized clinical trial

Amit Vinayak Nagrale et al. J Man Manip Ther. 2012 Feb.

Abstract

Previous case reports, case series, and pilot studies have suggested that slump stretching may enhance the effects of spinal mobilization and stabilization exercises in patients with non-radicular low back pain (NRLBP). The purpose of this trial was to determine if slump stretching results in improvements in pain, disability, and fear and avoidance beliefs in patients with NRLBP with neural mechanosensitivity. Sixty patients, 18-60 years of age presenting with NRLBP with symptom duration >3 months, were randomized into one of two, 3-week physical therapy programs. Group one received lumbar spinal mobilization with stabilization exercises while group two received slump stretching in addition to lumbar spinal mobilization with exercise. Outcomes including the modified Oswestry disability index (ODI), numeric pain rating scale (NPRS), and the fear-avoidance belief questionnaire (FABQ) were collected at baseline, and at weeks 1, 2, 3, and 6. A doubly multivariate analysis of variance revealed a significant group-time interaction for ODI, NPRS, and FABQ. There were large within-group changes for all outcomes with P<0·01 and large between-group differences at weeks 3 and 6 for the ODI and weeks 1, 2, 3, and 6 for the NPRS and FABQ at P<0·01. A linear mixed-effect model comparing the composite slopes of the improvement lines revealed significant differences favoring the slump stretching group at P<0·01. The findings of the present study further support the use of slump stretching with spinal mobilization and stabilization exercises when treating NRLBP.

Keywords: Low back pain; Neurodynamics; Slump stretching; Slump test.

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Figures

Figure 1
Figure 1
Slump stretch technique.
Figure 2
Figure 2
Self-slump stretching home exercise program.
Figure 3
Figure 3
CONSORT flow diagram.
Figure 4
Figure 4
Results of the linear mixed-effect model. The composite slopes were significantly different with group 2 improving faster than group 1.
Figure 5
Figure 5
Mean outcome scores with standard deviations. * denotes statistical significance.
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