Original Research ArticleInternational Journal of Research in Medical Sciences

Publication:
Effectiveness of Mulligan bent leg raise and instrument-assisted soft tissue mobilization techniques on hamstring flexibility and functional disability in non-specific low back pain: a randomized controlled trial

Int J Res Med Sci. 2026;14(9):3912-3918.DOI10.18203/2320-6012.ijrms20263105

Thumbnail Image
View on the journal's website(opens in a new tab)

Abstract

Background Non-specific low back pain or NSLBP, a musculoskeletal condition that results in pain, decreased flexibility, and functional impairment, is commonly associated with hamstring tightness. Manual therapy techniques like Mulligan Bent Leg Raise (BLR) and IASTM, or Instrument-Assisted Soft Tissue Mobilization are frequently used to improve hamstring flexibility and alleviate discomfort. However, there isn't much information comparing their effectiveness in individuals with NSLBP.

Methods A randomized comparison study was conducted with forty male volunteers, ages 18 to 40, who had tight hamstrings with NSLBP. Each of the two randomly allocated groups, Group A (Mulligan BLR) and Group B (IASTM), had 20 participants. Interventions were administered three times a week for two weeks. The outcomes were evaluated using the Numerical Pain Rating Scale (NPRS), the Quebec Back Pain Disability Scale (QBPDS), and Active Knee Extension Test (AKET).

Results Both groups' functional impairment, hamstring flexibility, and pain significantly improved after treatment (p=0.001). Between-group analysis revealed that the Mulligan BLR group had better reductions in NPRS scores (mean difference=2.00), better improvements in left and right AKET scores (mean differences=10.45° and 10.55°, respectively), and a greater reduction in QBPDS scores (mean difference=12.90) (p=0.001).

Conclusions Both Mulligan BLR and IASTM were effective in reducing pain, improving hamstring flexibility, and reducing functional impairment. However, Mulligan BLR demonstrated significantly better outcomes on all end measures and may be a more effective treatment for hamstring tightness associated with NSLBP.

Keywords

Affiliations

  1. Department of Physical Medicine and Rehabilitation (Physiotherapy), Government Medical College and Hospital, (Affiliated to the Tamil Nadu Dr. MGR Medical University) Annamalai Nagar, Cuddalore District, Tamil Nadu, India
  2. School of Physiotherapy, Vinayaka Missions Research Foundation, Kirumampakkam, Puducherry, Tamil Nadu, India
  3. Department of Physiotherapy, Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Science (SIMATS), Chennai, Tamil Nadu, India

Full item record