Non-specific Low Back Pain (NSLBP)NCT07181395
Mulligan Mobilization Techniques for Non-Specific Low Back Pain
A study testing Hip Internal Rotation Mulligan Mobilization, Straight Leg Raise Mulligan Mobilization and Conventional Physiotherapy in people with Non-specific Low Back Pain (NSLBP), run by Gazi University at 1 site in Turkey (Türkiye).
Trial summary
This study aims to compare the effectiveness of two different Mulligan mobilization techniques in patients with non-specific low back pain. A total of 30 adults with chronic low back pain will be randomly assigned to three groups: (1) conventional physiotherapy plus hip internal rotation Mulligan mobilization, (2)… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Non-specific Low Back Pain (NSLBP)
- What is being tested?
- Hip Internal Rotation Mulligan Mobilization, Straight Leg Raise Mulligan Mobilization and Conventional Physiotherapy
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 7 Sep 2025to 1 Dec 2025
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age ≥ 18 years
- Diagnosed with non-specific low back pain (NSLBP) for at least 3 months
- Able to walk independently
- Willing to participate and provide written informed consent
Who cannot join
- Specific causes of low back pain (e.g., disc herniation, spinal stenosis, tumor)
- Presence of neurological deficits or radiculopathy
- Hip joint pathologies limiting mobility (e.g., osteoarthritis)
- History of lumbar surgery in the last 6 months
- Diagnosed osteoporosis or osteopenia
- Contraindications for Mulligan mobilization
- Severe physical or cognitive impairments preventing participation
- Participation in other physiotherapy or manual therapy treatments during the study period
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site
Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation
Ankara, Ankara, 06500
Yusuf Kaan KAYA, MSc, PT, +09-505-013-81-65, fzt.yusufkaankaya@gmail.com
Rukiye ALTUNBAS, MSc, PT, +090-545-227-27-95, rukiskacar@gmail.com
About this study
Official title: Comparison of the Effectiveness of Two Different Mulligan Mobilization Techniques in Patients With Non-Specific Low Back Pain: A Triple-Blind Randomized Controlled Trial
This study aims to compare the effectiveness of two different Mulligan mobilization techniques in patients with non-specific low back pain. A total of 30 adults with chronic low back pain will be randomly assigned to three groups: (1) conventional physiotherapy plus hip internal rotation Mulligan mobilization, (2) conventional physiotherapy plus straight leg raise Mulligan mobilization, or (3) conventional physiotherapy only. The interventions will be applied twice a week for four weeks. The main outcomes are pain intensity (measured by Visual Analog Scale) and lumbar range of motion. Secondary outcomes include disability level (Oswestry Disability Index) and back awareness (Fremantle Back Awareness Questionnaire). The study will help determine whether Mulligan techniques provide additional benefits beyond conventional physiotherapy in reducing pain and improving function in people with non-specific low back pain.
Read the detailed description
Low back pain is the second most common cause of disability worldwide and significantly affects quality of life and healthcare systems. Non-specific low back pain (NSLBP) accounts for nearly 85% of all low back pain cases and is associated with loss of function, reduced productivity, and psychological problems. Physiotherapy approaches such as exercise, manual therapy, electrotherapy, and patient education are widely used, but not all patients benefit equally, highlighting the need for innovative and individualized treatment strategies. Mulligan mobilization is a manual therapy method that combines physiological joint movements with pain-free mobilization techniques. Techniques such as hip mobilization and traction-assisted straight leg raise (SLR) are thought to improve pain, range of motion, and functional outcomes. Although some studies suggest positive effects of Mulligan techniques, there is a lack of randomized controlled trials directly comparing different Mulligan approaches in patients with NSLBP. This triple-blind randomized controlled trial will investigate the comparative effectiveness of two Mulligan mobilization techniques. Thirty adults with NSLBP will be randomly assigned into three groups: (1) conventional physiotherapy plus hip internal rotation Mulligan mobilization, (2) conventional physiotherapy plus SLR Mulligan mobilization, and (3) conventional physiotherapy only. Interventions will be delivered twice a week for four weeks by experienced physiotherapists certified in the Mulligan Concept®. The primary outcomes will be pain intensity measured with the Visual Analog Scale (VAS) and lumbar range of motion assessed by goniometer. Secondary outcomes include disability level measured with the Oswestry Disability Index (ODI) and back awareness assessed with the Fremantle Back Awareness Questionnaire (FreBAQ). The findings of this study are expected to provide evidence on whether Mulligan mobilization techniques offer additional benefits beyond conventional physiotherapy in the management of non-specific low back pain.
- Conditions
- Non-specific Low Back Pain (NSLBP)
- Being tested
- Hip Internal Rotation Mulligan Mobilization, Straight Leg Raise Mulligan Mobilization, Conventional Physiotherapy
- Keywords
- Mulligan Mobilization, Hip Internal Rotation, Straight Leg Raise, Physiotherapy, Manual Therapy, Low Back Pain
- Medical subject headings
- Low Back Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Hip Internal Rotation Mulligan MobilizationBehavioural
Also called Mulligan Hip IR Mobilization
Mulligan mobilization applied to hip internal rotation using a mobilization belt. Performed in 3 sets of 10 repetitions, twice weekly for 4 weeks, in addition to conventional physiotherapy.
Straight Leg Raise Mulligan MobilizationBehavioural
Also called Mulligan SLR Mobilization
Mulligan mobilization applied to straight leg raise under manual traction. Performed in 3 sets of 10 repetitions (15-20 seconds hold), twice weekly for 4 weeks, in addition to conventional physiotherapy.
Conventional PhysiotherapyBehavioural
Also called Standard Physiotherapy
Conventional physiotherapy including transcutaneous electrical nerve stimulation (20 minutes), massage, lumbar stretching and strengthening exercises, postural training, and patient education. Delivered twice weekly for 4 weeks.
| Study group | Role | What they receive |
|---|---|---|
| Conventional Physiotherapy + Hip Internal Rotation Mulligan Mobilization | Experimental | Participants will receive conventional physiotherapy combined with Mulligan mobilization applied to hip internal rotation. The mobilization will be performed with a mobilization belt, 3 sets of 10 repetitions, twice weekly for 4 weeks. Receives: Behavioral: Hip Internal Rotation Mulligan Mobilization; Behavioral: Conventional Physiotherapy |
| Conventional Physiotherapy + Straight Leg Raise Mulligan Mobilization | Experimental | Participants will receive conventional physiotherapy combined with Mulligan mobilization applied to straight leg raise under traction. The mobilization will be performed in 3 sets of 10 repetitions (15-20 seconds hold), twice weekly for 4 weeks. Receives: Behavioral: Straight Leg Raise Mulligan Mobilization; Behavioral: Conventional Physiotherapy |
| Conventional Physiotherapy Only | Active comparator | Participants will receive conventional physiotherapy only, including transcutaneous electrical nerve stimulation (20 minutes), massage, stretching and strengthening exercises for lumbar muscles, postural training, and patient education. Treatment will be delivered twice weekly for 4 weeks. Receives: Behavioral: Conventional Physiotherapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain Intensity (Visual Analog Scale, VAS)
Pain intensity will be assessed using the Visual Analog Scale (VAS), a 100 mm horizontal line ranging from "no pain" to "worst pain imaginable." Participants will mark their pain level, and the distance in millimeters will be recorded.
Measured: Baseline (week 0) and post-treatment (week 4).
Lumbar Range of Motion (ROM)
Lumbar spinal range of motion will be measured using a goniometer. Participants will perform active forward flexion, and the angle of motion will be recorded in degrees.
Measured: Baseline (week 0) and post-treatment (week 4).
Secondary outcomes (2)
Disability Level (Oswestry Disability Index - ODI)
Functional disability will be assessed using the Oswestry Disability Index (ODI). The scale consists of 10 items, each scored from 0 to 5, with higher scores indicating greater disability. The total score ranges from 0 (no disability) to 50 (maximum disability).
Measured: Baseline (week 0) and post-treatment (week 4)
Back Awareness (Fremantle Back Awareness Questionnaire - FreBAQ)
Body perception related to the lumbar region will be measured using the Fremantle Back Awareness Questionnaire (FreBAQ). The questionnaire has 9 items scored on a Likert scale (0-4), with higher scores reflecting reduced back awareness.
Measured: Baseline (week 0) and post-treatment (week 4).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Sep 2025
- Study start7 Sep 2025 (estimated)
- Primary completion7 Oct 2025 (estimated)
- Study completion1 Dec 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Non-specific Low Back Pain (NSLBP)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 30 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Gazi University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Bulent ELBASAN, Gazi University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07181395
- Sponsor's protocol ID
- GU-ETHICS-2025-08-863
- Other IDs
- GU-Ethics-08/863
- Status last verified
- Sep 2025
- First submitted
- 12 Sep 2025
- Last updated
- 18 Sep 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 18 Sep 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Effectiveness of Two Different Mulligan Mobilization Techniques in Patients With Non-Specific Low Back Pain: A Triple-Blind Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07181395
- Acronym / sponsor ID
- GU-ETHICS-2025-08-863
- Conditions
- Non-specific Low Back Pain (NSLBP)
- Keywords
- Mulligan Mobilization, Hip Internal Rotation, Straight Leg Raise, Physiotherapy, Manual Therapy, Low Back Pain
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 30 participants (estimated)
- Lead sponsor
- Gazi UniversityUniversity, hospital or other
- Study start
- 7 Sep 2025 (estimated)
- Primary completion
- 7 Oct 2025 (estimated)
- Study completion
- 1 Dec 2025 (estimated)
- First posted
- 18 Sep 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to compare the effectiveness of two different Mulligan mobilization techniques in patients with non-specific low back pain. A total of 30 adults with chronic low back pain will be randomly assigned to three groups: (1) conventional physiotherapy plus hip internal rotation Mulligan mobilization, (2) conventional physiotherapy plus straight leg raise Mulligan mobilization, or (3) conventional physiotherapy only. The interventions will be applied twice a week for four weeks. The main outcomes are pain intensity (measured by Visual Analog Scale) and lumbar range of motion. Secondary outcomes include disability level (Oswestry Disability Index) and back awareness (Fremantle Back Awareness Questionnaire). The study will help determine whether Mulligan techniques provide additional benefits beyond conventional physiotherapy in reducing pain and improving function in people with non-specific low back pain.
Detailed description
Low back pain is the second most common cause of disability worldwide and significantly affects quality of life and healthcare systems. Non-specific low back pain (NSLBP) accounts for nearly 85% of all low back pain cases and is associated with loss of function, reduced productivity, and psychological problems. Physiotherapy approaches such as exercise, manual therapy, electrotherapy, and patient education are widely used, but not all patients benefit equally, highlighting the need for innovative and individualized treatment strategies. Mulligan mobilization is a manual therapy method that combines physiological joint movements with pain-free mobilization techniques. Techniques such as hip mobilization and traction-assisted straight leg raise (SLR) are thought to improve pain, range of motion, and functional outcomes. Although some studies suggest positive effects of Mulligan techniques, there is a lack of randomized controlled trials directly comparing different Mulligan approaches in patients with NSLBP. This triple-blind randomized controlled trial will investigate the comparative effectiveness of two Mulligan mobilization techniques. Thirty adults with NSLBP will be randomly assigned into three groups: (1) conventional physiotherapy plus hip internal rotation Mulligan mobilization, (2) conventional physiotherapy plus SLR Mulligan mobilization, and (3) conventional physiotherapy only. Interventions will be delivered twice a week for four weeks by experienced physiotherapists certified in the Mulligan Concept®. The primary outcomes will be pain intensity measured with the Visual Analog Scale (VAS) and lumbar range of motion assessed by goniometer. Secondary outcomes include disability level measured with the Oswestry Disability Index (ODI) and back awareness assessed with the Fremantle Back Awareness Questionnaire (FreBAQ). The findings of this study are expected to provide evidence on whether Mulligan mobilization techniques offer additional benefits beyond conventional physiotherapy in the management of non-specific low back pain.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Conventional Physiotherapy + Hip Internal Rotation Mulligan Mobilization | Experimental | Behavioral: Hip Internal Rotation Mulligan Mobilization, Behavioral: Conventional PhysiotherapyParticipants will receive conventional physiotherapy combined with Mulligan mobilization applied to hip internal rotation. The mobilization will be performed with a mobilization belt, 3 sets of 10 repetitions, twice weekly for 4 weeks. |
| Conventional Physiotherapy + Straight Leg Raise Mulligan Mobilization | Experimental | Behavioral: Straight Leg Raise Mulligan Mobilization, Behavioral: Conventional PhysiotherapyParticipants will receive conventional physiotherapy combined with Mulligan mobilization applied to straight leg raise under traction. The mobilization will be performed in 3 sets of 10 repetitions (15-20 seconds hold), twice weekly for 4 weeks. |
| Conventional Physiotherapy Only | Active comparator | Behavioral: Conventional PhysiotherapyParticipants will receive conventional physiotherapy only, including transcutaneous electrical nerve stimulation (20 minutes), massage, stretching and strengthening exercises for lumbar muscles, postural training, and patient education. Treatment will be delivered twice weekly for 4 weeks. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Age ≥ 18 years
- Diagnosed with non-specific low back pain (NSLBP) for at least 3 months
- Able to walk independently
- Willing to participate and provide written informed consent
Key exclusion criteria (8 listed)
- Specific causes of low back pain (e.g., disc herniation, spinal stenosis, tumor)
- Presence of neurological deficits or radiculopathy
- Hip joint pathologies limiting mobility (e.g., osteoarthritis)
- History of lumbar surgery in the last 6 months
- Diagnosed osteoporosis or osteopenia
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Hip Internal Rotation Mulligan MobilizationAlso: Mulligan Hip IR MobilizationMulligan mobilization applied to hip internal rotation using a mobilization belt. Performed in 3 sets of 10 repetitions, twice weekly for 4 weeks, in addition to conventional physiotherapy. | Behavioural | Conventional Physiotherapy + Hip Internal Rotation Mulligan Mobilization |
| Straight Leg Raise Mulligan MobilizationAlso: Mulligan SLR MobilizationMulligan mobilization applied to straight leg raise under manual traction. Performed in 3 sets of 10 repetitions (15-20 seconds hold), twice weekly for 4 weeks, in addition to conventional physiotherapy. | Behavioural | Conventional Physiotherapy + Straight Leg Raise Mulligan Mobilization |
| Conventional PhysiotherapyAlso: Standard PhysiotherapyConventional physiotherapy including transcutaneous electrical nerve stimulation (20 minutes), massage, lumbar stretching and strengthening exercises, postural training, and patient education. Delivered twice weekly for 4 weeks. | Behavioural | Conventional Physiotherapy + Hip Internal Rotation Mulligan Mobilization, Conventional Physiotherapy + Straight Leg Raise Mulligan Mobilization, Conventional Physiotherapy Only |
Primary outcome
Pain Intensity (Visual Analog Scale, VAS)
Time frame: Baseline (week 0) and post-treatment (week 4).
Pain intensity will be assessed using the Visual Analog Scale (VAS), a 100 mm horizontal line ranging from "no pain" to "worst pain imaginable." Participants will mark their pain level, and the distance in millimeters will be recorded.
Lumbar Range of Motion (ROM)
Time frame: Baseline (week 0) and post-treatment (week 4).
Lumbar spinal range of motion will be measured using a goniometer. Participants will perform active forward flexion, and the angle of motion will be recorded in degrees.
2 secondary outcomes
Disability Level (Oswestry Disability Index - ODI)
Time frame: Baseline (week 0) and post-treatment (week 4)
Back Awareness (Fremantle Back Awareness Questionnaire - FreBAQ)
Time frame: Baseline (week 0) and post-treatment (week 4).
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Sep 2025.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Hip Internal Rotation Mulligan Mobilization, Straight Leg Raise Mulligan Mobilization and Conventional Physiotherapy in people with Non-specific Low Back Pain (NSLBP), run by Gazi University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 18 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Yusuf Kaan KAYA (+90-505-013-81-65, fzt.yusufkaankaya@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain Intensity (Visual Analog Scale, VAS) (time frame: Baseline (week 0) and post-treatment (week 4).). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Sep 2025.