Immediate effects of joint mobilization on lumbar mobility and posterior chain flexibility

• Grant number: 23/08235-9
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2024
• End date: December 31, 2024
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Marcelo Tavella Navega
• Grantee: Samyra Masetto Rodrigues
• Host Institution: Faculdade de Filosofia e Ciências (FFC). Universidade Estadual Paulista (UNESP). Campus de Marília. Marília , SP, Brazil

Abstract

Low back pain (LD) can be defined as pain or discomfort referred to the lower part of the spine, between the last thoracic vertebra and the first sacral vertebra, above the superior gluteal line, which may or may not radiate to the lower limbs. Highly prevalent, it affects approximately 84% of the adult population at some point in life, and is considered chronic if it persists for more than 12 weeks. Currently, there are numerous proposals for conservative interventions for the treatment of chronic low back pain, which aim to relieve pain, increase functionality and prevent disease progression. Among them there are those that act on the causes and that, for this purpose, a detailed evaluation and a previous diagnosis are prescribed, taking for example kinesiotherapy. Others act on the signs and symptoms, exemplifying the techniques for analgesia. It is possible to observe breathing between the pain, reduction of range of motion and decrease of flexibility, which increases the severity of the LBP and can generate fatigue of the paraspinal muscles, progressively limiting functionality. Many resources are being used in physiotherapy practice for pain relief before, during and after physiotherapy sessions, thus enabling the performance of kinesiotherapeutic exercise programs and other complementary techniques that would be limited, interrupted or postponed by the presence of pain. A conservative approach applied to DLC is Manual Therapy, among which vertebral joint mobilization stands out. It is known that the restriction of joint mobility between the vertebrae of the spine can be aggravated by the lack of mobility and by the functional benefits that generate hypoactivity in the paraspinal muscles, which increases the chance of occurrence of inflammatory processes in the proximal lumbar structures. Spinal manipulation restores mobility on joint surfaces, promoting greater compliance and reducing mechanical traction, resulting in an improvement in pain and in the function of the segment where the technique is applied. The objective of the research is to analyze the immediate effects of vertebral joint movement on the mobility, strength and resistance of the lumbar spine in young adult individuals. This is a clinical, quantitative, randomized trial, which was submitted to the local committee ethics . The sample will consist of 40 adult individuals aged between 18 and 35 years, of both sexes, and two groups will be formed: Lumbar Joint Mobilization Group (GM, n=20) and Control Group (GC, n=20). The Schober Test will be applied to assess lumbar mobility, lumbar extension dynamometry, and the Biering-Sorensen test to assess the resistance of the trunk extensor muscles. After the initial assessment (AV1) the lumbar vertebral joint mobilization protocol will be applied for the GM and thoracic mobilization simulation for the GC. After 40 minutes of application of the intervention, the volunteers will be reassessed (AV2). The data obtained through the evaluations and applied tests will be analyzed with exploratory statistical techniques. After verifying the normality and homogeneity of the data, the appropriate statistical analysis will be adopted to compare the variables between groups and within each group. A significance level of p <0.05 will be adopted.