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THE INITIAL EFFECTS OF DIFFERENT RATES OF LUMBAR MOBILISATIONS ON PRESSURE PAIN THRESHOLDS IN ASYMPTOMATIC SUBJECTS



Abstract

Introduction: Lumbar mobilisations are commonly used in clinical practise to reduce pain and increase function. Mobilisations to the cervical spine have been shown to reduce pain using pressure pain thresholds (PPT). Yet there is no evidence to confirm that this happens in the lumbar spine. Furthermore there is little known about the effects of different treatment doses on the amount of hypoalgesia produced. It is unknown if changing the rate of application of mobilisations has an effect on hypoalgesia. The aim of this study was to investigate the immediate effects of lumbar posteroanterior mobilisations performed at different rates on PPT. Pressure pain thresholds were measured in a number of locations in order to assess the extent of the analgesic response.

Method and Results: A repeated measures single blind, randomised-trial was conducted on 30 asymptomatic subjects (22 female and 8 males). Pressure pain thresholds were measured at 4 sites in the upper and lower quadrants, before and after the application of lumbar spine posteroanterior mobilisations performed at 2Hz, 1Hz and quasi-static. The results demonstrated an immediate and significant improvement in PPT measures (P< 0.000) irrespective of the rate or site tested. The effects were both local and widespread. There was no significant difference between the rates of mobilisations on PPT.

Conclusion: This study provides new experimental evidence that lumbar spine posteroanterior mobilisations produce an immediate and significant widespread hypoalgesic effect, regardless of the rate of mobilisation. Further research is now needed to investigate the effect on a patient population with low back pain.

Correspondence should be addressed to SBPR at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.