The effects of a modified spinal mobilisation with leg movement (SMWLM) technique on sympathetic outflow to the lower limbs

Physiotherapy management of lumbar disorders, based on Mulligan's mobilization techniques, is a treatment of choice by many physiotherapists, however, there is only limited evidence of any neurophysiological effects and much of this has focused on the cervical spine and upper limbs. This study aims to extend the knowledge base underpinning the use of a modified Mulligan's spinal mobilisation with leg movement technique (SMWLM) by exploring its effects on the peripheral sympathetic nervous system (SNS) of the lower limbs. Using a single blind, placebo controlled, independent groups study design, 45 normal naive healthy males were randomly assigned to one of three experimental groups (control, placebo or treatment; SMWLM). SNS activity was determined by recording skin conductance (SC) obtained from lower limb electrodes connected to a BioPac unit. Validation of the placebo technique was performed by post- intervention questionnaire. Results indicated that there was a significant change in SC from baseline levels (30%) that was specific to the side treated for the treatment group during the intervention period (compared to placebo and control conditions). This study provides preliminary evidence that a modified SMWLM technique results in side-specific peripheral SNS changes in the lower limbs.