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Low back pain (LBP) is leading cause of disability and its burden is growing worldwide with an increasing and ageing of population. Poor flexibility or tightness of hamstring muscle has been associated with low back pain. It is a prominent cause of activity limitations and work absenteeism throughout world. Hence this study was designed to find out superior form of effective technique on active knee extension and experience of pain and disability in chronic nonspecific low back pain.
Low back pain (LBP) is leading cause of disability and it is most leading cause of work absenteeism throughout world. Poor flexibility or tightness of hamstring muscle has been associated with low back pain. Hence this study was designed to find out superior form of effective technique on hamstrings tightness and experience of pain and disability in chronic nonspecific low back pain. This study will also assist to set the foundation for further more studies designing magnificent protocols of treatment for affected population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A (Coventional treatment with Bowen Therapy) | Experimental | Group A will be treated with Bowen Technique in addition to conventional treatment. One session, 45 minutes for technique along with conventional treatment will be given. Technique will be performed for 10 minutes on each limb. The data will be collected at baseline and at 4th week. Follow up will be performed for 4 weeks and 3 sessions will be given each week. |
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| Group B (Conventional treatment with DSTM) | Active Comparator | Group B will be treated with Dynamic Soft Tissue Mobilizations (DSTM) in addition to conventional treatment. One session, 45 minutes for technique along with conventional treatment will be given. Technique will be performed for 10 minutes on each limb. The data will be collected at baseline and at 4th week. Follow up will be performed for 4 weeks and 3 sessions will be given each week. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Conventional therapy for hamstring tightness | Procedure | Conventional Physical therapy will include TENS , hot pack , Hamstring self stretch , Calf self stretching , bridging exercise , piriformis stretch , prone on hands and prone on elbows. |
| Measure | Description | Time Frame |
|---|---|---|
| Active knee extension test | active knee extension test, the participant will be in supine-lying position on the treatment bed. Then, participant will flex the hip to 90° while keeping the contralateral hip and knee extended on plinth. The goniometer's fulcrum will be placed on the lateral condyle of the femur at knee joint. The proximal arm of goniometer placed along with the long axis of femur, while moveable arm aligned in line with lateral malleolus. The subject will then extend the knee actively without any pain and tilting of pelvis. | 4 weeks |
| Active straight leg raise (aSLR) | The active straight leg raise will be conducted bilaterally three times, and best out of 3 attempts will be recorded. The classic straight leg raise is a complete active test. Each leg is tested individually. When performing the aSLR test, the patient is positioned in supine without a pillow under his/her head. The starting position is described with a distance of 20cm between feet. The patient must rise the leg 20cm from the starting position maintaining the knee in complete extension. The participant will be then asked to rate the difficulty of the task using a 6- point Likert scale. 6-point Likert scale (0= not difficult at all, 1 = minimally difficult, 2 = somewhat difficult, 3= fairly difficult, 4= very difficult, and 5= unable to perform). The test is considered positive when the subjective feeling of fatigue is >3. | 4 weeks |
| The sit-and-reach (SR) tests | The subjects sat on the flat surface with their head, back, and hips against a wall, knees straight, legs together, and soles of the feet positioned flat against Sit and Reach box. In keeping this position, the subject will be requested to extend the arms with palms down and lightly touch the index fingers together. The finger-to-box distance will be measured as the distance between the fingertips and the point at which the feet contacted to the box. Then, the subjects will be asked to bend forward slowly and reached as far forward as possible while keeping the knees extended and sliding their hands along a measuring scale placed on the box. Throughout the test, examiner will check to ensure that the heels remained at the box and that the knees are fully extended. The 0 cm mark of the measuring scale represent the position of the feet against the box, with larger values for better performance having higher flexibility. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain intensity | Pain status of patients will be assessed using NPRS. | 4 Weeks |
| Disability | Disability will be assessed using RMDQ. | 4 Weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Maryam Tariq, MS MSKPT | Contact | +923165360826 | marytareq2097@gmail.com | |
| Saba Murad | Contact | +923478669827 | saba.murad@fui.edu.pk |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fauji Foundation Hospital Department of Rehabilitation | Recruiting | Rawalpindi | Punjab Province | 46000 | Pakistan |
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| Bowen Technique | Procedure | Bowen Technique:
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| Dynamic Soft Tissue Mobilization (DSTM): | Procedure |
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| 4 weeks |
| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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