This study aimed to determine the combined treatment effects of Mulligan sustained natural apophyseal glides (SNAGs) and low-level laser therapy (LLLT) on function, pain, and range of motion (ROM) in patients with chronic low back pain. A total of 49 adults participated in this study and were randomly divided into three groups (SNAGs with LLLT group, SNAGs group, and control group). The participants in the SNAGs with LLLT group received SNAGs for 10 min, LLLT for 10 min, and electrotherapy for 10 min. The SNAGs group received SNAGs for 10 min and electrotherapy for 20 min. The control group received electrotherapy for 30 min. All participants received the assigned treatment for 30 min a day, 3 times a week, for 4 weeks. We used the visual analogue scale (VAS) to measure pain, the modified-modified Schober test (MMST) to measure ROM, and the Roland Morris disability questionnaire (RMDQ) to measure physical disability. Compared to the pre-intervention values, the VAS and MMST scores significantly increased after the intervention in the SNAGs with LLLT group (p = 0.000) and the SNAGs group (p = 0.000). The RMDQ score significantly improved in the SNAGs with LLLT (p = 0.000), SNAGs (p = 0.000) and control (p = 0.025) group after the intervention. The inter-group differences were greater for the SNAGs with LLLT and SNAGs groups than for the control group (p = 0.001), and the difference was greater for the SNAGs with LLLT than for the SNAGs (p = 0.001) with respect to the VAS, MMST, and RMDQ scores. These results indicate that significant improvement in pain, function, and ROM may be achieved by a combination of SNAGs and LLLT to treat chronic low back pain.

Objective: The purpose of this study was to compare ankle function between adults with and without Down syndrome (DS). Design: Cross-sectional study. Methods: Ten adults with DS and 18 without participated in this study and underwent manual muscle test (MMT), range of motion (ROM) assessment, star excursion balance test (SEBT), and functional movement screen (FMS). The tests were demonstrated to increase their accuracy and the actual measurements were assessed after one or two demonstrations. To minimize the standby time and fatigue, the travelled distance and measuring order were adjusted. To remove the influence of shoes on the measurements, the shoes were taken off and only socks were worn. Results: Dorsal and plantar flexion MMTs of both ankles were significantly weaker and plantar flexion ROM of both ankles were significantly lower in adults with DS compared with those without (p<0.05). However, dorsal flexion ROM of both ankles were not significantly different between them. There were significant differences in distances measured in all the directions (anterior, anterolateral, lateral, posterolateral, posterior, posteromedial, medial, and anteromedial directions) of SEBT (p<0.05). Significant differences were also demonstrated in the scores of hurdle step, inline lunge, shoulder mobility, and rotary stability among the seven items of FMS (p<0.05). Conclusions: To enhance the dynamic stability of adults with DS, it is necessary to improve ankle stability by strengthening the ankle dorsal and plantar flexors.