Musculoskeletal Ultrasound to Evaluate the Effect of 4D PRO Suspension Rope Training Combined with Mulligan Technique on Non-specific Low Back Pain: A Single-blind Randomized Controlled Trial

Cong Wang, Wendong Zhang, Yu Zhang, Di Zhang, Guannan Zhang

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¹ Hebei Institute of Sports Science, Sports Medical Rehabilitation Center, Shijiazhuang 050011, Hebei, China,

² Hebei Provincial People’s Hospital, Rehabilitation Department, Shijiazhuang 050051, Hebei, China,

³ School of Materials Science and Engineering, Hebei University of Science and Technology, Shijiazhuang 050018, Hebei, China,

BAS 2025 , 3(5), 37–46; https://doi.org/10.26689/bas.v3i5.12683

© 2025 by the Authors. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Abstract

This trial was designed to evaluate the effects of 4D PRO suspension rope exercise combined with the Mulligan technique in non-specific low back pain (NLBP) patients by musculoskeletal ultrasound and clinical indicators. Sixty patients were randomly divided into the suspension group and the control group for eight weeks. The two groups were also treated with the Mulligan manipulation. The suspension group was treated combined with suspension rope training, while the control group was treated combined with traditional rehabilitation training. Pain, lumbar function and spinal range of motion were measured by a specialist before and after treatment. In addition, musculoskeletal ultrasound was used to measure the thickness of bilateral transversalis and multifidus muscles. After eight weeks, muscle thickness of bilateral transversalis and multifidus muscles, NRS, ODI and spinal range of motion in two groups were significantly better than those before treatment (P<0.05)). The suspension group showed significantly improvement compared to the control group regarding pain, lumbar function, spinal range of motion and the thickness of bilateral transversalis and multifidus muscles(P<0.05). 4D PRO Suspension rope training may be an effective exercise as an adjunctive therapy with Mulligan technology in non-specific low back pain.

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