COMPARISON OF MCKENZIE LUMBAR EXTENSION PROTOCOL VERSUS LUMBAR MAITLAND MOBILIZATION ON PAIN, DYNAMIC SPINAL STABILITY, AND PARASPINAL MUSCLE ACTIVITY IN YOUNG ADULTS WITH NONSPECIFIC LOW BACK PAIN: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Nonspecific low back pain (NSLBP) is a prevalent musculoskeletal condition, especially in young adults. Despite various physiotherapeutic approaches, optimal treatment protocols remain a subject of ongoing investigation. McKenzie Lumbar Extension Exercises and Maitland Mobilization are frequently used techniques, yet their comparative effectiveness on pain, spinal stability, and muscle activation has not been fully explored. Objective: To compare the effects of McKenzie Lumbar Extension Protocol and Lumbar Maitland Mobilization on pain intensity, dynamic spinal stability, and paraspinal muscle activity in young adults with NSLBP. Methodology: A single-blinded randomized controlled trial was conducted over six months at a physiotherapy department, KTH, Peshawar. Sixty participants aged 18–35 years with clinically diagnosed NSLBP were randomly allocated into two groups (n=30 each). Group A received the McKenzie Lumbar Extension Protocol, while Group B underwent Maitland Mobilization, both administered thrice weekly for 6 weeks. Outcome measures included Numeric Pain Rating Scale (NPRS), dynamic stability tests, and electromyographic (EMG) activity of lumbar paraspinal muscles. Assessments were recorded at baseline and post-intervention. Results: Both interventions significantly reduced pain and improved dynamic stability and EMG activity (p<0.05). However, the McKenzie group showed statistically greater improvements across all parameters compared to the Maitland group (p<0.01). Conclusion: The McKenzie Lumbar Extension Protocol is more effective than Maitland Mobilization in improving pain, functional stability, and muscle activation in young adults with NSLBP. These findings advocate for incorporating McKenzie exercises in rehabilitation protocols targeting mechanical back pain in physically active individuals.