Comparison of Feng spinal mobilization with Maitland mobilization in management of chronic nonspecific low back pain: A cohort study

Abstract

Feng spinal mobilization (FSM) is one of the most widely practiced techniques in traditional Chinese osteopathy, especially in China. However, whether this FSM technique is more effective than the Maitland posteroanterior mobilization (MM), which is widely used all over the world, is still unknown. The purpose of this study was to retrospectively analyze and compare the efficacy of these 2 treatments in patients with chronic nonspecific low back pain (CNLBP) as to provide a basis for the clinical treatment of chronic low back pain. A total of 83 patients, including 43 patients in the FSM group and 40 in the MM group, were enrolled in this cohort study. FSM or MM was performed on patients 3 times during a period of 2 weeks. Changes in the subjective and objective measurements were measured before and after the third treatment. The subjective symptoms recorded included the visual analogue scale (VAS), Oswestry disability index, and Patient Health Questionnaire-9. The objective symptoms, including the lumbar range of motion (ROM), and straight leg raise (SLR) height were also checked for any changes. The VAS scores were reassessed at the 1-year follow-up visit. The results showed that 2 weeks of FSM treatment significantly improved CNLBP patients modified Schober test (P < .05), extension ROM (P < .01), and SLR height (P < .05) while MM treatment did not. Both treatments significantly decreased the values of VAS, Oswestry disability index, and Patient Health Questionnaire-9 (P < .01). Compared to the MM treatment, the FSM treatment showed a much more significant improvement in VAS score (P < .01), range of motion of extension (P < .01), and SLR of both sides (P < .05). At the 1-year follow-up, VAS scores in both groups decreased significantly compared to pretreatments; however, there was no significant difference between the 2 groups. Our data suggested that the FSM treatment can provide better efficacy than MM in CNLBP patients, improving the VAS scores, lumbar extension ROM, and SLR height in a shorter time. Abbreviations: CNLBP = chronic nonspecific low back pain, FSM = Feng spinal mobilization, LDH = lumbar disc herniation, MM = Maitland posteroanterior mobilization, mSchober test = modified Schober test, ODI = Oswestry disability index, PHQ-9 = Patient Health Questionnaire-9, ROM = lumbar range of motion, SLR = straight leg raise, VAS = visual analogue pain scale.