Effectiveness of Maitland Mobilisation on Pain and Function in Individuals with Mechanical Low Back Pain: A Systematic Review

Introduction: Mechanical Low Back Pain (MLBP) is a prevalent condition that significantly impacts individuals' quality of life and healthcare systems worldwide. The management of MLBP has explored various manual therapy techniques, including Maitland mobilisation; however, the immediate effects and comparative efficacy of these techniques remain subjects of ongoing investigation. Aim: To evaluate the immediate effects of Maitland mobilisation compared to other manual therapy techniques on flexion and extension Range of Motion (ROM) in patients with MLBP. Materials and Methods: The present systematic review involved a comprehensive search of electronic databases, including PubMed, Cochrane Library, and Google Scholar, from January 2017 to March 2024. The search utilised the keywords "Randomised Controlled Trials (RCTs)", "Maitland mobilisation", and "mechanical low back pain". Studies comparing the immediate effects of Maitland mobilisation with other manual therapy techniques on flexion and extension ROM in patients with MLBP were included. Data extraction and quality assessment were performed using established protocols. Results: Nine studies met the inclusion criteria and were included in the review. The findings revealed that Maitland mobilisation demonstrated significant immediate effects on both flexion and extension ROM in patients with MLBP. Improvements were particularly noted in lumbar flexion following Maitland mobilisation, while lumbar extension showed greater enhancement after specific techniques such as Posteroanterior (PA) mobilisation. Additionally, combination therapies, such as core stability exercises coupled with Maitland manual therapy, showed promising results in reducing disability associated with MLBP. Conclusion: This review investigated the immediate effects of Maitland mobilisation on ROM in MLBP. While some studies indicated improvements in ROM, the evidence for its effectiveness compared to other interventions and its longterm impact on pain and function remains unclear. Future well- designed studies are needed to definitively assess the role of Maitland mobilisation in the management of MLBP.