The initial effects of different rates of lumbar mobilisations on pressure pain thresholds in asymptomatic subjects

Abstract 

Lumbar mobilisations are commonly used in clinical practice to reduce pain and increase function. Mobilisations to the cervical spine have been shown to reduce pain using pressure pain thresholds (PPTs). Yet there is no evidence to confirm that this happens in the lumbar spine. Furthermore little is known about the effects of different treatment doses on the amount of hypoalgesia produced. It is unknown if changing the rate of application of mobilisations has an effect on hypoalgesia. The aim of this study was to investigate the immediate effects of lumbar posteroanterior mobilisations performed at different rates on PPT and the extent of the hypoalgesia.

A repeated measures, single blind, randomised-trial was conducted on 30 asymptomatic subjects. PPTs were measured at 4 sites in the upper and lower quadrants, before and after the application of lumbar posteroanterior mobilisations performed at 2 Hz, 1 Hz and quasi-static. The results demonstrated an immediate and significant improvement in PPT measures (P = 0.000) irrespective of the rate or site tested. The effects were both local and widespread. There was no significant difference in PPT between the rates of mobilisations.

This study provides new experimental evidence that lumbar posteroanterior mobilisations produce an immediate and significant widespread hypoalgesic effect, regardless of the rates of mobilisation in asymptomatic subjects.

Keywords: Mobilisations, Manual therapy, Pressure pain thresholds, Lumbar spine