Assessment of Lumbar Spine Kinematics by Posterior-to-Anterior Mobilization

Objective: Studies confirming the lumber spine kinematics of direct or indirect segmental mobility under the application of joint mobilization, which induces passive force on the spine, are insufficient.Therefore, this study aims to obtain the underlying clinical data by identifying direct or indirect segmental mobility produced by Maitland's PA mobilization technique. Design: Randomized controlled trial design. Methods: Thirty subjects with no back pain participated in this study. X-ray testing equipment (SIG-40-525, Ecoray Inc., Korea) was used to verify the segmented movement of their lumbar. Joint mobilization was performed by physiotherapists with more than 10 years of experience in prescription therapy, and radiography was performed once without PA joint mobilization and once without the mobilization for comparing the lumbar vertebrae before and after the mobilization. The radiographs taken were analyzed using the picture archiving and communication system (PACS) program to measure the spinal displacement, intervertebral height, intervertebral angle, and lumbar lordosis angle. Results: Significant differences were observed in the lumbar displacement, intervertebral angle, and lumbar lordosis angle in all lumbar vertebrae before and after the mobilization. The intervertebral height indicated significant differences in all ventral vertebrae and only in L3-L4 and L4-L5 in dorsal vertebrae. Conclusions: This study suggests that the segmental mobility produced through indirect approaches plays an important role in inducing therapeutic effects in patients with back pain.