Regenerative Rehabilitation in Musculoskeletal Conditions: Integrating Biologic Therapies with Targeted Rehabilitation Approaches

Purpose: Chronic low back pain (CLBP) is a prevalent musculoskeletal condition associated with pain, disability, and reduced quality of life.Although inversion table therapy and Mulligan techniques have individually demonstrated therapeutic benefits, comparative evidence between the two interventions remains limited.This study aims to evaluate the differential effects of inversion table therapy and Mulligan techniques on pain intensity and lumbar flexibility in adults with CLBP.Methods: A double-blinded randomized controlled trial was conducted across multiple private clinical facilities in Lahore, enrolling adults aged 30-50 years with clinically diagnosed CLBP.Participants were randomly assigned to two equal groups following similar baseline treatment.Group 1 received inversion table therapy, while Group 2 underwent Mulligan techniques.Outcome measures included pain intensity using the Numeric Pain Rating Scale (NPRS), disability using the Oswestry Disability Index (ODI), lumbar flexibility via the Sit-and-Reach Test (SRT), and quality of life using the RAND SF-36.Data analysis was performed using SPSS version 26, with between-and within-group comparisons assessed through appropriate statistical tests.Results: Between-group analysis showed no significant differences for NPRS and RAND SF-36 scores (p > 0.05), indicating comparable effects on pain intensity and quality of life.However, significant differences were observed for ODI and SRT outcomes (p < 0.05), demonstrating superior disability reduction with Mulligan techniques and greater improvements in lumbar flexibility with inversion table therapy.Within-group analyses indicated significant improvements across all outcomes for both interventions.Conclusion: Both inversion table therapy and Mulligan techniques demonstrated meaningful clinical benefits for patients with chronic low back pain.Mulligan techniques were more effective in reducing disability, whereas inversion table therapy yielded greater improvements in lumbar flexibility.These findings support the targeted use of each intervention based on individualized patient needs in physiotherapy practice.