Maitland Mobilization vs. McKenzie Press-Up in Chronic LBP

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.

Inclusion criteria

• 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.

Exclusion criteria

• 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.