To Study the Effectiveness of Butler’s Neural Mobilization Versus Maitland's Spinal Mobilization in Lumbar Radiculopathy
DOI:
https://doi.org/10.53555/ejac.v20i1.1153Abstract
Background: Lumbar is a common and debilitating condition characterized by radiating pain, numbness, and functional disability due to nerve root compression or irritation. Maitland Spinal Mobilization (MSM) and Butler’s Neural Mobilization (BNM) are widely used manual therapy techniques to relive symptoms due to nerve compression.. This study aimed to evaluate and compare the efficacy of MSM and BNM in managing lumbar radiculopathy. Methods: A randomized controlled trial was conducted with 30 participants diagnosed with lumbar radiculopathy, randomly assigned to two groups: Group A (MSM) and Group B (BNM). Both groups received their respective manual therapy techniques combined with conventional physiotherapy (hot pack and ultrasound therapy) over ten sessions in two weeks. Pain intensity and functional disability were assessed pre- and post-intervention using the Numeric Pain Rating Scale (NPRS) and Oswestry Disability Index (ODI). Statistical analysis included paired and independent t-tests, with a significance level of p < 0.05. Results: Both groups showed significant reductions in NPRS and ODI scores post-intervention (p < 0.001). However, Group A demonstrated greater improvements in pain intensity and functional disability compared to Group B. Maitland Spinal Mobilization was more effective in reducing joint-related dysfunction, whereas Butler’s Neural Mobilization was effective but less impactful in addressing the symptoms of lumbar radiculopathy. Conclusion: This study shows that Maitland Spinal Mobilization showed superior outcomes, suggesting its prioritization in cases with lumbar radiculopathy.References
Deyo RA, Mirza SK. Clinical practice. Herniated lumbar intervertebral disk. N Engl J Med. 2016;374(18):1763-72.
Frymoyer JW. Lumbar disc disease: epidemiology. Instr Course Lect. 1992;41:217-23.
Maitland GD. Vertebral Manipulation. 7th ed. Elsevier; 2001.
Shacklock M. Clinical Neurodynamics: A New System of Neuromusculoskeletal Treatment. Elsevier; 2005.
Stochkendahl MJ, Christensen HW. The effect of spinal manipulation in the treatment of lumbar radiculopathy. J Manipulative Physiol Ther. 2008;31(8):520-5.
Coppieters MW, Butler DS. Do ‘sliders’ slide and ‘tensioners’ tension? An analysis of neurodynamic techniques and considerations regarding their application. Man Ther. 2008;13(3):213-21.
Ellis RF, Hing WA. Neural mobilization: a systematic review of randomized controlled trials with an analysis of therapeutic efficacy. J Manual Manipulative Ther. 2008;16(1):8-22.
Takasaki H, May S. Mechanical diagnosis and therapy for the treatment of sciatica caused by a lumbar disc herniation. J Orthop Sports Phys Ther. 2014;44(11):854-68.
Butler DS. The Sensitive Nervous System. Noigroup Publications; 2000.
Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine. 2000;25(22):2940-52.
Cleland JA, Fritz JM, Brennan GP. Predictors of treatment response in patients with lumbar radiculopathy receiving conservative care. Spine. 2006;31(18):1920-5.
Hahne AJ, Ford JJ, McMeeken JM. Conservative management of lumbar disc herniation with associated radiculopathy: a systematic review. Spine. 2010;35(11):E488-504.