COMPARISON OF EFFECTIVENESS OF JOINT

MOBILIZATION AND HOT PACK FOR CHRONIC LOW

BACK PAIN: RESULTS OF A RANDOMIZED CONTROL
TRIAL WITH SIX MONTHS FOLLOW-UP
Lecturer in-charged : Dr. Ajau Danis & En Khairil Md Isa
Presenter members :
1. Atiya Nadhrah bt Hassan

(2013283706)

2. Fatin Farhanah bt Alham

(2013240016)

3. Nur Faza bt Rosli (2013629096)

4. Nur Izzati Shahira bt Che Azmi

(2013281462)

5. Siti Syafiqah bt Saufi(2013804104)

INTRODUCTION
Back pain is a common problem and a major cause of
disability and health care utilization. Low back pain is pain,
muscle tension, or stiffness, localized below the costal
margin and above the inferior gluteal folds, with or without
referred or radicular leg pain (sciatica)

PROBLEM STATEMENTS
In hospital setting, mostly patients who came with a low back pain will be
managed using hot packs instead of manual technique; joint mobilization. This
is because manual technique is time consuming in compared to hot packs.
Despite it all, joint mobilization techniques is believed to be effective in
reducing pain compared to thermal therapy.
Hence, we would like to carry out study to find the effectiveness of
intervention between hot pack and joint mobilization in reducing chronic low
back pain.

RESEARCH QUESTIONS
Does joint mobilization can reduce the source of low back pain instead of hot
packs?
Does joint mobilization is effective to treat low back pain?
Does hot pack effective in reducing lower back pain?

OBJECTIVE
To compare the effectiveness between joint mobilization and
hot packs in reducing the pain among chronic low back pain
patient.

HYPOTHESIS
H0 = There is no difference between the usage of hot packs and joint
mobilization can reduce the pain effectively in low back pain patient.
H1 = Low back pain patient that undergo joint mobilization treatment has
lower pain scale than hot packs treatment.

SAMPLING DESIGN
PARTICIPANT:
Inclusion
Outpatient
Chronic low back pain
Age 25-40
Mechanical back pain
Habitual incorrect posture

Exclusion
Diabetic Mellitus
Osteoporosis
Rheumatoid arthritis
Neurological symptom
Pregnant
Herniated disc (PID)
Bone fracture
Tuberculosis
Trauma injury

SETTING
Held around Selangor area using multicentered research trial.
Involved Sungai Buloh Hospital and PPUM.
Gain patient information from Physiotherapy Department.
Randomly select patients from spine division in Physiotherapy Department .

SAMPLING METHOD
Participant will be recruited based on voluntarily for each eligibility
participant based on inclusion and exclusion criteria and will be assigned
based on random allocation into either intervention or control.

INTERVENTION
Hot pack
Patient is being given hot pack at lower lumbar region for 20 minutes.
Joint mobilization
Using grade I and II oscillation technique, do 30 times oscillatory over lower
lumbar region (L1-L5), repeat for 3 sets.

RESEARCH INSTRUMENT
SAMMONS PRESTON Tropic Hydrocollator Hot Pack
Manual technique of joint mobilization
Using Visual analog scale (VAS) to measure pain level.
Oswestry Low Back Pain Disability Questionnaire

Figure 1.0 Sammon

Preston Tropic 9
Hydrocollator Hot
Pack

DATA MEASUREMENT
Statistical Package for the Social Sciences 22.0 version (SPSS)
Visual Analog Scale (VAS)
Oswestry Low Back Pain Disability Questionnaire

10

DATA COLLECTION
We fix our participant selection within two weeks.

Pt. who come to department will be given a consent form.

Select patient according to inclusion and exclusion criteria

For the control group will be treated using hot pack; the
intervention group treated using joint mobilization
Followed-up for 24 weeks and treatment will be given 11once
a week for both group with their assign tx.

LIMITATION OF THE STUDY

Patient drop out from the study due to prolong processes of research
duration.
Techniques of joint mobilization applied will be differed among
physiotherapist.

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WORK SCHEDULE/GANTT CHART

Tasks

Proposal writing
Conducting
study
Data collection
Data analysis
Report
writing/final

To completed by (months)
No
v
1
4

De
c
1
4

Ja
n
1
5

Fe
b
1
5

M
ac
1
5

Ap
r
1
5

M
ay
1
5

Ju
ne
1
5

Jul
y
1
5

Au
g
1
5

Se
pt
1
5

Oc
t
1
5

/
/
13

Figure 1.0 Visual Analog Scale (VAS), a measurement

used to measured pain scale before and after

14

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Figure 1.2 Oswestry Low Back Pain Disability Questionnaire