Abstract
Background: Patients with low back pain (LBP) tend to have prolonged treatment periods, which
increase the cost of medical care. Several studies have reported that lumbar spine range of motion
(ROM) and hip muscle flexibility are factors in LBP. Sustained natural apophyseal glides (SNAGs)
have reportedly improved the lumbar spine ROM and hip flexibility of LBP patients. Moreover, self-
SNAGs can be performed by the patients themselves.
Aim: This study aimed to evaluate the short-term effects of self-SNAGs on lumbar spine ROM
compared to a repeated movement procedure in asymptomatic college students.
Methods: A prospective crossover study was conducted on 14 asymptomatic male college students.
The asymptomatic participants performed self-SNAGs or repeated movements (i.e., three sets per
day, 6 times a day over 1 week), and the compliance rate for both exercises was recorded. The
lumbar spine ROM (i.e., flexion, extension, lateral bending, and rotation) was measured using the
back ROM instrument, and hip muscle flexibility was measured using the Thomas test, heel-buttock
distance, finger-floor distance, and straight leg raise test (SLR). Measurements were taken before
commencement, immediately after, and 1 week later.
Results: Left lateral bending and left SLR were excluded from the between-group comparison (self-
SNAG and sham) due to a carryover effect (P < 0.05). A comparison between the self-SNAG and
sham groups displayed no significant differences in the lumbar spine ROM and hip muscle flexibility
(P > 0.05).
Conclusion: Our study revealed that lumbar self-SNAGs had no significant effect on lumbar spine
ROM or hip muscle flexibility in the short term, suggesting that such movements should be avoided
when stretching to prevent LBP. However, this study did not include subjects with limited lumbar
spine ROM and hip muscle flexibility due to pain, warranting further validation in future studies.
Relevance for Patients: The effects of lumbar self-SNAGs were similar to that of sham exercises in
healthy individuals without joint ROM restrictions in the trunk or lower extremities due to LBP
DOI: https://doi.org/10.36922/jctr.23.00091
Author affiliation
1Department of Physical Therapy, Graduate School of Medicine, Saitama Medical University, Saitama, Japan
2Department of Rehabilitation,
Kawagoe Clinic, Saitama Medical University, Saitama, Japan, 3School of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical
University, Saitama, Japan
4Department of Rehabilitation, Major of Physical Therapy, School of Health Sciences, Tokyo University of Technology,
Tokyo, Japan
5Department of Rehabilitation, Saitama Medical University Saitama Medical Center, Saitama, Japan, 6School of Allied Health in
Physiotherapy, Curtin University, Perth, Australia
*Corresponding author:
Kiyokazu Akasaka
Department of Physical Therapy, Graduate
School of Medicine, Saitama Medical
University, Moroyama, Saitama, Japan/School
of Physical Therapy, Faculty of Health and
Medical Care, Saitama Medical University,
Saitama, Japan.
Email: akasaka-smc@umin.ac.jp
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