INTRODUCTION
The high incidence rates and prevalence rates of low
back pain are well-known1). Most low back pain patients
have pain in the lumbosacral region, and symptoms include
a reduced ROM.
It has been reported that joint mobilization is effective
for the relief of pain and improvement of ROM2, 3). Although
most types of joint mobilization comprise passively
applied intervention methods, sustained natural apophyseal
glides (SNAGS), which has recently been used in clinics, is
an intervention method that requires the performance of a
type of joint mobilization in combination with patients’ active
movements. The method is known to be effective4). Despite
this, SNAGS has a defect: the effect on mobility may
be dispersed because undesired motions are quite likely to
occur in the lower lumbar vertebrae joints. When SNAGS is
performed to increase the extension ROM, certain lumbar
vertebrae joints are compressed to induce apophyseal joint
gliding. However, it is difficult to control motions in joints
other than fixed joints. Due to the power of the muscle contraction
generated during active extension by the patient,
who is under the influence of gravity, motions may occur
not only in the joints that require an increase in ROM, the
joints between L1-2, L2-3, and L3-4, but also in the joints
between L4-5 and L5-S1. The net effect of joint mobilization
in certain joints with hypo-mobility is therefore reduced.
To improve the lumbar extension ROM of low back pain
patients, the present study performed Gong’s mobilization
using accurate fixing, gravity, weight, and acceleration,
while the therapist induced passive motions instead of the
patient’s active motions. Consequently, motions occurred
only in those joints where the therapist wanted motion, that
is, the upper lumbar vertebrae joints that required increases
in extension ROM. This study examined the effect of the
performance of Gong’s mobilization on lumbar extension
ROM.