Back Pain Lower BackLBPNCT07364721
Maitland Mobilization vs. McKenzie Press-Up in Chronic LBP
A study testing Group B (McKenzie PPU exercise with MFR), Central Posteroanterior Mobilization and McKenzie PPU exercise with MFR in people with Back Pain Lower Back, run by Palestine Ahliya University at 1 site in Palestinian Territories.
Trial summary
ABSTRACT Objective:This study aimed to compare the efficacy of central posteroanterior (PA) Maitland mobilization with myofascial release (MFR) and McKenzie prone press-up (PPU) exercise with MFR in the treatment of adult patients with chronic non-specific low back pain (CNLBP). Read more about this study
- Who is it for?
- Ages 18 to 50 years
- Conditions the study is for
- Back Pain Lower Back
- What is being tested?
- Group B (McKenzie PPU exercise with MFR), Central Posteroanterior Mobilization and McKenzie PPU exercise with MFR
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 1 sitePalestinian Territories
- Study dates
- 1 Dec 2023to 1 May 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
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 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- 18 and 50 years of age,
- Male or female, with NSLBP localized between the lower rib and the gluteal fold
- Persisting for more than three months and occurring on at least half of the days in the past three months, with pain affecting daily functional activities.
- VAS score between 40 mm and 80 mm at the initial assessment
- No use of NSAID medications during treatment sessions.
Who cannot join
- Patients younger than 18 or older than 50 years,
- Those with mental health disorders, systemic or neurological diseases, or specific spinal pathologies such as facet joint dysfunction, piriformis syndrome, disc herniation, spinal tumors, spondylitis, spondylolisthesis, spinal stenosis, or spinal osteoporosis. Patients were also excluded if they had contraindications to mobilization, a history of spinal surgery or epidural injections, physiotherapy for LBP within the last six months, a VAS score outside the 40-80 mm range, pregnancy, or a current upper limb injury.
Trial locations and contacts
1 site in 1 country.
Palestinian Territories1 site
Palestine Ahliya University
Bethlehem, West Bank, P150
About this study
Official title: Comparative Efficacy of Maitland Mobilization vs. McKenzie Press-Up in Chronic Low Back Pain: A Randomized Trial
ABSTRACT Objective:This study aimed to compare the efficacy of central posteroanterior (PA) Maitland mobilization with myofascial release (MFR) and McKenzie prone press-up (PPU) exercise with MFR in the treatment of adult patients with chronic non-specific low back pain (CNLBP). Materials and Methods:A randomized controlled trial was conducted at Salhab Center and Al Shifa's Specialized Complex in Bethlehem between January 2023 and May 2024. The study included 50 adult patients (aged 18-50) with CNLBP of more than 3 months but less than 2 years' duration, referred by an orthopedic specialist at Beit Sahour Medical Center. Participants were randomly assigned to two groups: one received central PA Maitland mobilization with MFR, and the other received McKenzie PPU exercise with MFR. Pain intensity, functional impairment, and fear-avoidance beliefs were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Fear-Avoidance Beliefs Questionnaire (FABQ). Each patient underwent three sessions per week for four weeks.
Read the detailed description
This randomized controlled trial evaluated physiotherapy interventions in adults with chronic non-specific low back pain (CNLBP). The study was conducted at Salhab Center for Physiotherapy and Al Shifa's Specialized Complex in Bethlehem City between December 2023 and May 2024. These centers were selected for their accessibility and coordinated referral system.
Participants were referred from orthopedic assessment to physiotherapy, where baseline evaluations were completed prior to randomization. Random allocation to intervention groups was performed using a concealed allocation method.
Physiotherapy interventions were delivered by licensed physiotherapists according to standardized treatment protocols to ensure consistency. Treatment sessions consisted of structured therapeutic exercises and manual therapy techniques, with progression individualized based on patient response. Outcome data were collected at baseline and at the end of the intervention period using validated assessment tools. Participant adherence and adverse events were monitored throughout the study. All procedures were conducted in accordance with ethical standards, and informed consent was obtained from all participants.
- Conditions
- Back Pain Lower Back
- Being tested
- Group B (McKenzie PPU exercise with MFR), Central Posteroanterior Mobilization, McKenzie PPU exercise with MFR
- Keywords
- McKenzie Exercise, Low back pain, Posteroanterior mobilization
- 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.
Group B (McKenzie PPU exercise with MFR)Other
Patient position: The patient assumes a prone position. Therapist position: The therapist stands beside the patient and provides verbal instruction.
Direction: Patients were being instructed to perform PPU exercise by using their upper limbs to push their upper body up into spinal extension while the pelvis remained on the treatment table. The patient is trained to extend the lumbar spine to the maximum pain-free range.
Frequency: Ten repetitions for three sets with a 30-second break between each set for almost 10 minutes
Central Posteroanterior MobilizationOther
According to Maitland's concept, mobilization technique including passive accessory intervertebral movement was applied to cause movement in the stiff vertebral segment without the active involvement of the muscles [44]. Central PA mobilization technique is a cornerstone of Maitland vertebral mobilization [38]. It can be achieved by passive force onto a vertebral segment in the PA direction [44].
Patient position: When applying this technique, the patient assumes a relaxed and comfortable prone position, with the arms positioned alongside the body [23, 24].
investigator position: The investigator stands close to the patient, with their sternum perpendicular to the selected lumbar spinous process [23]. The investigator uses the ulnar surface of the hand (pisiform) over the selected spinous process in the lumbar spine, another hand taken was placed above the first hand to reinforce, and the elbow should slightly bent with forearm in neutral between supination \& pronation.
McKenzie PPU exercise with MFROther
Patient position: The patient assumes a prone position. investigator position: The investigator stands beside the patient and provides verbal instruction.
Direction: Patients were being instructed to perform PPU exercise by using their upper limbs to push their upper body up into spinal extension while the pelvis remained on the treatment table. The patient is trained to extend the lumbar spine to the maximum pain-free range.
Frequency: Ten repetitions for three sets with a 30-second break between each set for almost 10 minutes
| Study group | Role | What they receive |
|---|---|---|
| Arm 1- Group A :Central PA Maitland mobilization with MFR | Experimental | Central PA Maitland mobilization with MFR Receives: Other: Group B (McKenzie PPU exercise with MFR); Other: McKenzie PPU exercise with MFR |
| Arm 2- Group B:McKenzie PPU exercise with MFR | Experimental | Patient position: The patient assumes a prone position. investigator position: The investigator stands beside the patient and provides verbal instruction.
Direction: Patients were being instructed to perform PPU exercise by using their upper limbs to push their upper body up into spinal extension while the pelvis remained on the treatment table. The patient is trained to extend the lumbar spine to the maximum pain-free range.
Frequency: Ten repetitions for three sets with a 30-second break between each set for almost 10 minutes [27]. Receives: Other: Group B (McKenzie PPU exercise with MFR); Other: Central Posteroanterior Mobilization |
What is being measured
The primary outcome is the main question the study is designed to answer.
Oswestry Disability Index
0% (no disability) to 100% (severe disability)
Measured: 4 WEEKS
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Jan 2026
- Study start1 Dec 2023
- Primary completion1 Apr 2024
- Study completion1 May 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Back Pain Lower BackStudies 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
- Model description
- The treatment techniques applied to the two groups are as follows. Group A (Central PA Maitland mobilization with MFR): 25 patients received 3 sessions per week for 4 weeks; the central PA mobilization technique was applied for 10 minutes and MFR for 20 minutes (30 seconds break each five minutes). Group B (McKenzie PPU exercise with MFR): 25 patients received three sessions per week for four weeks, with each session consisting of 10 minutes of McKenzie PPU exercise followed by 20 minutes of MFR, also with a 30-second break every five minutes.
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 50 participants (actual)
Sponsor and investigators
- Lead sponsor
- Palestine Ahliya University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Azzam Alarab, Palestine Ahliya University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07364721
- Sponsor's protocol ID
- Palestine Ahliya U
- Acronym
- LBP
- Status last verified
- Jan 2026
- First submitted
- 3 Jan 2026
- Last updated
- 23 Jan 2026
- Results posted
- No
- Data monitoring committee
- Yes
- 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 23 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Efficacy of Maitland Mobilization vs. McKenzie Press-Up in Chronic Low Back Pain: A Randomized Trial
- ClinicalTrials.gov ID
- NCT07364721
- Acronym / sponsor ID
- LBP / Palestine Ahliya U
- Conditions
- Back Pain Lower Back
- Keywords
- McKenzie Exercise, Low back pain, Posteroanterior mobilization
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 50 participants (actual)
- Lead sponsor
- Palestine Ahliya UniversityUniversity, hospital or other
- Study start
- 1 Dec 2023 (actual)
- Primary completion
- 1 Apr 2024 (actual)
- Study completion
- 1 May 2024 (actual)
- First posted
- 23 Jan 2026 (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.
ABSTRACT Objective:This study aimed to compare the efficacy of central posteroanterior (PA) Maitland mobilization with myofascial release (MFR) and McKenzie prone press-up (PPU) exercise with MFR in the treatment of adult patients with chronic non-specific low back pain (CNLBP). Materials and Methods:A randomized controlled trial was conducted at Salhab Center and Al Shifa's Specialized Complex in Bethlehem between January 2023 and May 2024. The study included 50 adult patients (aged 18-50) with CNLBP of more than 3 months but less than 2 years' duration, referred by an orthopedic specialist at Beit Sahour Medical Center. Participants were randomly assigned to two groups: one received central PA Maitland mobilization with MFR, and the other received McKenzie PPU exercise with MFR. Pain intensity, functional impairment, and fear-avoidance beliefs were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Fear-Avoidance Beliefs Questionnaire (FABQ). Each patient underwent three sessions per week for four weeks.
Detailed description
This randomized controlled trial evaluated physiotherapy interventions in adults with chronic non-specific low back pain (CNLBP). The study was conducted at Salhab Center for Physiotherapy and Al Shifa's Specialized Complex in Bethlehem City between December 2023 and May 2024. These centers were selected for their accessibility and coordinated referral system.
Participants were referred from orthopedic assessment to physiotherapy, where baseline evaluations were completed prior to randomization. Random allocation to intervention groups was performed using a concealed allocation method.
Physiotherapy interventions were delivered by licensed physiotherapists according to standardized treatment protocols to ensure consistency. Treatment sessions consisted of structured therapeutic exercises and manual therapy techniques, with progression individualized based on patient response. Outcome data were collected at baseline and at the end of the intervention period using validated assessment tools. Participant adherence and adverse events were monitored throughout the study. All procedures were conducted in accordance with ethical standards, and informed consent was obtained from all participants.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
- Model description
- The treatment techniques applied to the two groups are as follows. Group A (Central PA Maitland mobilization with MFR): 25 patients received 3 sessions per week for 4 weeks; the central PA mobilization technique was applied for 10 minutes and MFR for 20 minutes (30 seconds break each five minutes). Group B (McKenzie PPU exercise with MFR): 25 patients received three sessions per week for four weeks, with each session consisting of 10 minutes of McKenzie PPU exercise followed by 20 minutes of MFR, also with a 30-second break every five minutes.
| Arm | Type | Receives |
|---|---|---|
| Arm 1- Group A :Central PA Maitland mobilization with MFR | Experimental | Other: Group B (McKenzie PPU exercise with MFR), Other: McKenzie PPU exercise with MFRCentral PA Maitland mobilization with MFR |
| Arm 2- Group B:McKenzie PPU exercise with MFR | Experimental | Other: Group B (McKenzie PPU exercise with MFR), Other: Central Posteroanterior MobilizationPatient position: The patient assumes a prone position. investigator position: The investigator stands beside the patient and provides verbal instruction. Direction: Patients were being instructed to perform PPU exercise by using their upper limbs to push their upper body up into spinal extension while the pelvis remained on the treatment table. The patient is trained to extend the lumbar spine to the maximum pain-free range. Frequency: Ten repetitions for three sets with a 30-second break between each set for almost 10 minutes [27]. |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- 18 and 50 years of age,
- Male or female, with NSLBP localized between the lower rib and the gluteal fold
- Persisting for more than three months and occurring on at least half of the days in the past three months, with pain affecting daily functional activities.
- VAS score between 40 mm and 80 mm at the initial assessment
- No use of NSAID medications during treatment sessions.
Key exclusion criteria (2 listed)
- Patients younger than 18 or older than 50 years,
- Those with mental health disorders, systemic or neurological diseases, or specific spinal pathologies such as facet joint dysfunction, piriformis syndrome, disc herniation, spinal tumors, spondylitis, spondylolisthesis, spinal stenosis, or spinal osteoporosis. Patients were also excluded if they had contraindications to mobilization, a history of spinal surgery or epidural injections, physiotherapy for LBP within the last six months, a VAS score outside the 40-80 mm range, pregnancy, or a current upper limb injury.
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 |
|---|---|---|
| Group B (McKenzie PPU exercise with MFR)Patient position: The patient assumes a prone position. Therapist position: The therapist stands beside the patient and provides verbal instruction. Direction: Patients were being instructed to perform PPU exercise by using their upper limbs to push their upper body up into spinal extension while the pelvis remained on the treatment table. The patient is trained to extend the lumbar spine to the maximum pain-free range. Frequency: Ten repetitions for three sets with a 30-second break between each set for almost 10 minutes | Other | Arm 1- Group A :Central PA Maitland mobilization with MFR, Arm 2- Group B:McKenzie PPU exercise with MFR |
| Central Posteroanterior MobilizationAccording to Maitland's concept, mobilization technique including passive accessory intervertebral movement was applied to cause movement in the stiff vertebral segment without the active involvement of the muscles [44]. Central PA mobilization technique is a cornerstone of Maitland vertebral mobilization [38]. It can be achieved by passive force onto a vertebral segment in the PA direction [44]. Patient position: When applying this technique, the patient assumes a relaxed and comfortable prone position, with the arms positioned alongside the body [23, 24]. investigator position: The investigator stands close to the patient, with their sternum perpendicular to the selected lumbar spinous process [23]. The investigator uses the ulnar surface of the hand (pisiform) over the selected spinous process in the lumbar spine, another hand taken was placed above the first hand to reinforce, and the elbow should slightly bent with forearm in neutral between supination \& pronation. | Other | Arm 2- Group B:McKenzie PPU exercise with MFR |
| McKenzie PPU exercise with MFRPatient position: The patient assumes a prone position. investigator position: The investigator stands beside the patient and provides verbal instruction. Direction: Patients were being instructed to perform PPU exercise by using their upper limbs to push their upper body up into spinal extension while the pelvis remained on the treatment table. The patient is trained to extend the lumbar spine to the maximum pain-free range. Frequency: Ten repetitions for three sets with a 30-second break between each set for almost 10 minutes | Other | Arm 1- Group A :Central PA Maitland mobilization with MFR |
Primary outcome
Oswestry Disability Index
Time frame: 4 WEEKS
0% (no disability) to 100% (severe disability)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Jan 2026.
- 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. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Group B (McKenzie PPU exercise with MFR), Central Posteroanterior Mobilization and McKenzie PPU exercise with MFR in people with Back Pain Lower Back, run by Palestine Ahliya University at 1 site in Palestinian Territories.
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 5 inclusion and 2 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: finished, as of the sponsor's last update on 23 Jan 2026. 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 Palestinian Territories. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Oswestry Disability Index (time frame: 4 WEEKS). 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 23 Jan 2026.