manuelletherapie 2014; 18(04): 177-184
DOI: 10.1055/s-0034-1390148
Originalia
Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Auswirkungen einer einmaligen, posterior-anterioren Mobilisation in End-of-Range-Position auf die lumbale Beweglichkeit in Flexion

Effects of a Single Posterior-Anterior Mobilisation in End-of-Range-Position on the Lumbar Flexion Range of Motion
Miriam Friede
1   Fachhochschule Kärnten, Studiengang Physiotherapie, St. Veiter Str. 47, 9020 Klagenfurt am Wörthersee, Österreich
› Author Affiliations
Further Information

Publication History

03 September 2013

01 December 2013

Publication Date:
14 October 2014 (online)

Zusammenfassung

Manuelle Mobilisationen durch posterior-anteriore Bewegung werden häufig zur Behandlung von Schmerzen und Bewegungseinschränkungen der Wirbelsäule eingesetzt. Bisherige Untersuchungen kommen zu unterschiedlichen Ergebnissen, was den Effekt einer einmaligen posterior-anterioren Mobilisation auf die LWS-Beweglichkeit betrifft. Für die lumbale Flexion ließen sich nach einmaliger posterior-anteriorer Mobilisation keine signifikanten Veränderungen nachweisen.

Das Ziel dieser Studie bestand darin, Veränderungen der segmentalen LWS-Beweglichkeit in Flexionsrichtung nach einmaliger standardisierter posterior-anteriorer Mobilisation in End-of-Range-Position im Vergleich zur Lagerung ohne zusätzliche Intervention nachzuweisen.

Bei asymptomatischen Probanden ergab sich nach einmaliger posterior-anteriorer Mobilisation in End-of-Range-Position im Vergleich zur Lagerung ohne Mobilisation kein statistisch signifikanter Unterschied in der LWS-Beweglichkeit in Flexionsrichtung. Die erhobenen Daten zeigten jedoch deutlich, dass die Reaktion auf die Mobilisation von der individuellen Beweglichkeit vor der Intervention abhängt.

Abstract

Manual mobilisation using posterior anterior movements are often employed in the treatment of spinal pain and restricted spinal movement. Previous research shows varying results concerning the effect of posterior anterior mobilisation on lumbar spinal mobility. No significant changes in lumbar flexion have been found following one-off posterior anterior mobilisation.

The aim of this study was to identify changes in segmental lumbar spinal mobility in flexion following standardised single posterior anterior mobilisations in end of range position compared to positioning without additional intervention.

No significant differences in lumbar spinal mobility in flexion could be found in asymptomatic subjects following single posterior anterior mobilisation in comparison to positioning without mobilisation. However, the collected data showed distinctively that the reaction to the mobilisation depends on the individual mobility before intervention.

 
  • Literatur

  • 1 Allison G, Edmonston S, Kiviniemi K et al. Influence of standardized mobilization on the posteroanterior stiffness of the lumbar spine in asymptomatic subjects. Physiotherapy Research International 2001; 6: 145-166
  • 2 Bronfort G, Haas M, Evans R et al. Effectiveness of manual therapies: the UK evidence report. Chiropractic & Osteopathy 2010; 18: 1-33
  • 3 Chiradejnant A, Maher C, Latimer J et al. Efficacy of “therapist-selected” versus “randomly-selected” mobilisation techniques for the treatment of low back pain – A randomised controlled trial. Australian Journal of Physiotherapy 2003; 49: 233-241
  • 4 Goodsell M, Lee M, Latimer J. Short-term effects of lumbar posteroanterior mobilisation in individuals with low-back pain. Journal of Manipulative and Physiological Therapeutics 2000; 23: 332-342
  • 5 Guermazi M, Ghroubi S, Kassis M et al. Validity and reliability of Spinal Mouse to assess lumbar flexion. Annales de readaptation et de medecine physique 2006; 49: 172-177
  • 6 Harms M, Bader D. Variability of forces applied by experienced therapists during spinal mobilization. Clinical Biomechanics 1997; 12: 393-399
  • 7 Hengeveld E. Das Maitland Konzept und Clinical Reasoning. In: Westerhuis P, Wiesner R, (Hrsg) Klinische Muster in der Manuellen Therapie: IMTA-Kurshandbuch Level 2a und b. Stuttgart: Thieme; 2011
  • 8 Kaltenborn F, Evjenth O, Baldauf Kaltenborn T et al. Manuelle Therapie nach Kaltenborn – Untersuchung und Mobilisation der Gelenke. Oslo: Norli; 2005
  • 9 Kellis E, Adamou G, Tzilios G et al. Reliability of Spinal Range of Motion in Healthy Boys Using a Skin-Surface Device. Journal of Manipulative and Physiological Therapeutics 2008; 31: 570-576
  • 10 Krekoukias G, Petty N, Cheek L. Comparison of surface electromyographic activity of erector spinae before and after the application of central posteroanterior mobilisation on the lumbar spine. Journal of Electromyography and Kinesiology 2009; 19: 39-45
  • 11 Lee R, Evans J. An in vivo study of the intervertebral movements produced by posteroanterior mobilization. Clinical Biomechanics 1997; 12: 400-408
  • 12 Maitland G, Hengeveld E, Banks K et al. Maitland – Manipulation der Wirbelsäule. Heidelberg: Springer; 2008
  • 13 Mannion A, Knecht K, Balaban G et al. A new skin-surface device for measuring the curvature and global and segmental ranges of motion of the spine: reliability of measurements and comparison with data reviewed from the literature. European Spine Journal 2004; 13: 122-136
  • 14 McCollam R, Benson C. Effects of Postero-anterior Mobilization on Lumbar Extension and Flexion. Journal of Manual & Manipulative Therapy 1993; 1: 134-141
  • 15 McGill S, Brown S. Creep response of the lumbar spine to prolonged full flexion. Clinical Biomechanics 1992; 7: 43-46
  • 16 Petty N. The effect of posteroanterior mobilisation on sagittal mobility of the lumbar spine. Manual Therapy 1995; 1: 25-29
  • 17 Post R, Leferink V. Spinal mobility: sagittal range of motion measured with the SpinalMouse, a new non-invasive device. Archives of Orthopaedic and Trauma Surgery 2004; 124: 187-192
  • 18 Powers C, Beneck G, Kulig K et al. Effects of a Single Session of Posterior-to-Anterior Spinal Mobilization and Press-up Exercise on Pain Response and Lumbar Spine Extension in People with Nonspecific Low Back Pain. Physical Therapy 2008; 88: 485-493
  • 19 Reichert B. Anatomie in vivo. Bd. 2: Palpieren und verstehen im Bereich Rumpf und Kopf. Stuttgart: Thieme; 2007
  • 20 Schomacher J. Manuelle Therapie – Bewegen und Spüren lernen. Stuttgart: Thieme; 2011
  • 21 Shirley D, Ellis E, Lee M. The response of posteroanterior lumbar stiffness to repeated loading. Manual Therapy 2002; 2: 18-23
  • 22 Snodgrass SJ, Rivett DA, Robertson VJ. Manual forces applied during posterior-to-anterior spinal mobilization: a review of the evidence. Journal of Manipulative and Physiological Therapeutics 2006; 29: 316-329
  • 23 Snodgrass SJ, Rivett D, Robertson V et al. Forces applied to the cervical spine during posteroanterior mobilization. Journal of Manipulative and Physiological Therapeutics 2009; 32: 72-83
  • 24 Stamos-Papastamos N, Petty N, Williams J. Changes in bending stiffness and lumbar spine range of movement following lumbar mobilization and manipulation. Journal of Manipulative and Physiological Therapeutics 2011; 34: 46-53
  • 25 Sterling M, Jull G, Wright A. Cervical mobilisation: concurrent effects on pain, sympathetic nervous system activity and motor activity. Manual Therapy 2001; 6: 72-81
  • 26 Taesung K, Gunsoo H, Byungjun C. Intrarater Reliability and Interrater Reliability in Spinal Motion Assessments. Journal of Physical Therapy Sciences 2010; 22: 301-306
  • 27 Taylor M, Survinen T, Reade P. The effect of Grade IV distraction mobilisation on patients with temporomandibular pain-dysfunction disorder. Physiotherapy Theory and Practice 1994; 10: 129-136