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The purpose of the study is to compare the effect of positional release technique and manual pressure technique of hip flexors on pain, range of motion, lumbosacral angle and disability in patients with chronic low back pain
This will be Randomized clinical trial. Individuals who met inclusion criteria will be included in this study. All participants will go through randomization and divided into two groups. Pre intervention assessment is made for both groups. Then intervention will apply to both groups. Group A will receive positional release technique and Group B will be treated by manual pressure technique and pain, range of motion, lumbosacral angle and functional disability will be measured before and after the treatment using NPRS, Inclinometer and ODI. Estimated time of treatment protocol will be 30 minutes per session, 4 times/week for 4 weeks in the hospital setting. Subjects will be evaluated at baseline and 4th week assessment will be the final.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Positional release technique | Experimental | Positional release technique will be applied on iliopsoas muscle. |
|
| Manual pressure technique | Experimental | Manual pressure technique will be applied on iliopsoas muscle. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Positional Release Technique | Device | Positional Release Technique will be applied on iliopsoas muscle. Treatment time will be 30 minutes per session, 4 times/week for 4 weeks in the hospital setting. |
| Measure | Description | Time Frame |
|---|---|---|
| Hip flexors tightness | Hip flexors tightness will be assessed using an inclinometer to measure the range of motion (ROM) for active hip extension and Lumbosacral angle | 4th week |
| Pain Intensity | Pain intensity will be evaluated using the Numeric Pain Rating Scale (NPRS) | 4th week |
| Functional disability | Functional disability will be assessed by Oswestry disability questionnaire. | 4th week |
| Anterior pelvic tilt | Anterior pelvic tilt will be measured using an inclinometer | 4th week |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Imran Amjad, phD | Contact | 03324390125 | imran.amjad@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Saba Rafique, phD | Riphah International University, Lahore | Principal Investigator |
| Faiza Alzaf | Riphah International University, Lahore | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| DHQ and tertiary hospitals | Recruiting | Khanewal | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 9502361 | Background | Juker D, McGill S, Kropf P, Steffen T. Quantitative intramuscular myoelectric activity of lumbar portions of psoas and the abdominal wall during a wide variety of tasks. Med Sci Sports Exerc. 1998 Feb;30(2):301-10. doi: 10.1097/00005768-199802000-00020. | |
| 25550670 | Background | Avrahami D, Potvin JR. The clinical and biomechanical effects of fascial-muscular lengthening therapy on tight hip flexor patients with and without low back pain. J Can Chiropr Assoc. 2014 Dec;58(4):444-55. |
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| Manual Pressure Technique | Device | Manual Pressure Technique will be applied on iliopsoas muscle. Treatment time will be 30 minutes per session, 4 times/week for 4 weeks in the hospital setting. |
|
| 30276017 | Background | Aslan H, Buddhadev HH, Suprak DN, San Juan JG. ACUTE EFFECTS OF TWO HIP FLEXOR STRETCHING TECHNIQUES ON KNEE JOINT POSITION SENSE AND BALANCE. Int J Sports Phys Ther. 2018 Aug;13(5):846-859. |
| 21665125 | Background | Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):769-81. doi: 10.1016/j.berh.2010.10.002. |
| Background | Naik Prashant P, Anand H, Khatri Subhash M. Comparison of muscle energy technique and positional release therapy in acute low back pain-RCT. Physiotherapy and Occupational Therapy. 2010;32 |
| 25561513 | Background | Deyo RA, Von Korff M, Duhrkoop D. Opioids for low back pain. BMJ. 2015 Jan 5;350:g6380. doi: 10.1136/bmj.g6380. |
| 31034509 | Background | Gonzalez-Galvez N, Gea-Garcia GM, Marcos-Pardo PJ. Effects of exercise programs on kyphosis and lordosis angle: A systematic review and meta-analysis. PLoS One. 2019 Apr 29;14(4):e0216180. doi: 10.1371/journal.pone.0216180. eCollection 2019. |
| 7730392 | Background | Santaguida PL, McGill SM. The psoas major muscle: a three-dimensional geometric study. J Biomech. 1995 Mar;28(3):339-45. doi: 10.1016/0021-9290(94)00064-b. |
| 24704126 | Background | Licciardone JC, Kearns CM, Crow WT. Changes in biomechanical dysfunction and low back pain reduction with osteopathic manual treatment: results from the OSTEOPATHIC Trial. Man Ther. 2014 Aug;19(4):324-30. doi: 10.1016/j.math.2014.03.004. Epub 2014 Mar 18. |
| Background | Chaitow L. Positional Release Techniques E-Book: Elsevier health sciences; 2007 |
| Background | Ibraheem EEMAE. Conventional therapy versus positional release technique in the treatment of chronic low back dysfunction. Int J Physiother Res. 2017;5(5):2325-31 |
| 9831771 | Background | Hanson P, Magnusson SP, Simonsen EB. Differences in sacral angulation and lumbosacral curvature in black and white young men and women. Acta Anat (Basel). 1998;162(4):226-31. doi: 10.1159/000046437. |
| 2711246 | Background | Mosner EA, Bryan JM, Stull MA, Shippee R. A comparison of actual and apparent lumbar lordosis in black and white adult females. Spine (Phila Pa 1976). 1989 Mar;14(3):310-4. doi: 10.1097/00007632-198903000-00011. |
| Background | Naik MS, Shah DN. Prevalence of tightness in hip joint muscles in middle aged women engaging in prolonged desk job: Descriptive study. Age. 2022;43:6.077908 |
| Background | AWATEF ML, ALI FAM, SHIMAA T, MAGDA GS. Effect of lumbar hyperlordosis correction on craniovertebral angle in low back pain patients. The Medical Journal of Cairo University. 2020;88(December):2051-7. |
| D013568 |
| Pathological Conditions, Signs and Symptoms |