الفهرس 
The combined effect of maitland spinal mobilization with mechanical lumbar traction in patients with chronic Nonspecific low back pain
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Abstract
Background: Nonspecific low back pain (NSLBP) is pain not attributed to a well- known cause or disease, represents 90{u2013}95% of the cases of LBP, which has effects on mobility and function. Purpose: This study was conducted to investigate the effect of Maitland spinal mobilization combined with mechanical lumbar traction on pain intensity level, lumbar range of motion (ROM), and functional disability level in treating of patients with chronic NSLBP. Materials and methods: Forty-four patients with chronic NSLBP participated in this study from both gender (21 females and 23 males), ranging in age from 20 to 30 years. Participants were distributed to four equal groups at random. Each group had eleven patient and received three sessions per week for four weeks: group (A) (Control group): received conventional physical therapy (Transcutaneous electrical nerve stimulation, Infrared and isometric exercise) and advices. group (B): in addition to conventional physical therapy and advices, participants received Maitland central posterior-anterior mobilization. group (C): in addition to conventional physical therapy and advices, participants received intermittent mechanical lumbar traction. group (D): in addition to conventional physical therapy and advices, participants received Maitland central posterior-anterior mobilization with intermittent mechanical lumbar traction. Outcome measures: Pain intensity level was assessed by visual analogue scale (VAS), lumbar ROM was assessed by Bubble Inclinometer, and functional disability was assessed by the Arabic version of Modified Oswestry Disability Questionnaire (MODQ). All outcomes were measured pre and post treatment. Results: Multivariate ANOVA revealed significance difference between groups (F=3.822, P=0.00), with the major changes favored group D, where )P ( 0.04 < compared to baseline where (P < 0.001). Conclusion: The combined treatment of Maitland spinal mobilization and mechanical lumbar traction is more effective than treatment by one of them alone on the pain intensity level, lumbar ROM, and functional disability level in treating of patients with chronic NSLBP