Effectiveness of Mulligan bent leg raise and instrument-assisted soft tissue mobilization techniques on hamstring flexibility and functional disability in non-specific low back pain: a randomized controlled trial

Abstract

Background: Non-specific low back pain or NSLBP, a musculoskeletal condition that results in pain, decreased flexibility, and functional impairment, is commonly associated with hamstring tightness. Manual therapy techniques like Mulligan Bent Leg Raise (BLR) and IASTM, or Instrument-Assisted Soft Tissue Mobilization are frequently used to improve hamstring flexibility and alleviate discomfort. However, there isn't much information comparing their effectiveness in individuals with NSLBP. Methods: A randomized comparison study was conducted with forty male volunteers, ages 18 to 40, who had tight hamstrings with NSLBP. Each of the two randomly allocated groups, Group A (Mulligan BLR) and Group B (IASTM), had 20 participants. Interventions were administered three times a week for two weeks. The outcomes were evaluated using the Numerical Pain Rating Scale (NPRS), the Quebec Back Pain Disability Scale (QBPDS), and Active Knee Extension Test (AKET). Results: Both groups' functional impairment, hamstring flexibility, and pain significantly improved after treatment (p=0.001). Between-group analysis revealed that the Mulligan BLR group had better reductions in NPRS scores (mean difference=2.00), better improvements in left and right AKET scores (mean differences=10.45° and 10.55°, respectively), and a greater reduction in QBPDS scores (mean difference=12.90) (p=0.001). Conclusions: Both Mulligan BLR and IASTM were effective in reducing pain, improving hamstring flexibility, and reducing functional impairment. However, Mulligan BLR demonstrated significantly better outcomes on all end measures and may be a more effective treatment for hamstring tightness associated with NSLBP.