Evaluation of the effect of multi segmental foot and ankle mobilization on pain, disability and lumbar and ankle flexion range of motion on patient with chronic mechanical low back pain (Randomized controlled trial)

Determining the effect of multi-segmental mobilization of the ankle and foot on pain, disability and range of motion(ROM) of the lumbar and ankle flexion in people with chronic mechanical low back pain.

Clinical trials with two control and experimental groups, parallel, single-blind, randomized using a table of random numbers will be performed on 56 patients.

The researcher selects 56 women with chronic mechanical low back pain. All screening forms are numbered before classification and will be kept for analysis until the end of the study. After filling out the consent form, all assessments are performed by a therapist unaware of the plan and then the individuals are randomly placed in two control and experimental groups by using the table of random numbers by the student and the patients are unaware. These studies will be performed in Berjis physiotherapy.

inclusion: woman; age: 30-60 years old; VAS more than 3; chronic pain; BMI less than 30; navicular bone drop more than 10mm; ankle dorsiflexion less than 20; first metatarsophalangeal joint extension less than 65 exclusion:Absence of systemic diseases such as diabetes and rheumatoid arthritis; Fractures in the trunk and lower limbs; Infection; Pregnancy; Tumor; Acute ankle sprains; Ankle ankylosis; Open sores on the feet; have not medical insoles; Lack of use of physiotherapy, massage therapy and manipulation in the last month; Lack of permanent pain in the lower limbs especially below the knee, and positive straight leg raising(SLR) and well SLR

Control group: Ten sessions of therapy including TENS, hot pack, exercise therapy and education Experimental group: In addition to the above, multi-segmental mobilization of the ankle and foot is also performed.

pain; disability; lumbar and ankle flexion ROM

In this study, we use random block method to assign patients to two control and experimental groups. In this method, blocks of 4, 6 and 8 or blocks that have an even number can be used. In this study, we will use quadruple blocks in which two people will be assigned to the experimental group and two to the control group. A quadruple block can be formed into 6 possible states according to the laws of probability. First, we identify these 6 possible cases and assign them the number one to six. In the next step, we determine the required number of blocks, which because the number of samples is 56 people, it is necessary to define this number in the form of 14 blocks of 4 people.In other words, in order to assign patients to two groups of 28 people, 14 times must be selected from codes 1 to 6, which is for possible cases of block formation. To do this, with the eyes closed and the tip of the pencil in the table of random numbers, we select a one-digit number and move in one of four directions, and We will select only numbers from one to six. We will continue this process until we randomly select 14 times from the numbers 1 to 6. Next, we write the blocks on a piece of paper, and select them in order of selection, depending on which of the modes constitutes the 4-person block. For example, if the first selected number is code 5 and the fifth mode of formation of 4 blocks is ABBA mode, it means that the first person will be assigned to group A, the second to B, the third to B and the fourth to A. As patients enter the study, the selected blocks will determine which of the two experimental or control groups each individual should be placed in. Finally, 56 patients will be assigned to one of the two groups of intervention (n = 28) and control (n = 28) during the study according to 14 blocks of 4.

Subjects are randomly assigned to treatment and control groups by researchers and are aware of the study and the type of treatment they receive. However, the evaluator is unaware of the groups being treated and the type of treatment in each group. Therefore, the study is a single-blind type. The tests are then taken and recorded by the evaluator unaware to the groups and treatment. After treatment, the tests are repeated by the same evaluator and the results are recorded.