Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Muscular imbalance due to prolonged sitting or standing posture leads to a condition lower cross syndrome(LCS) or lumbopelvic syndrome. Several stretching and strengthening regimens are used to treat cross pattern of muscular tightness and weakness in LCS. This study aims to compare the effects of Sahrmann's versus Janda's approach on pain, pelvic tilt and lumbar lordosis in lower crossed syndrome patients.
This study will be a randomized clinical trial and will be conducted in physiotherapy department of Rasheed Hospital, DHA. Non probability convenience sampling will be used to collect data. Sample size of 54 with age group between 18 to 40 years will be taken. Data will be collected from the patient who fulfilled the criteria of LCS. Outcome measures will be taken by using Numeric Pain Rating Scale (NPRS) for pain, I Handy Level for Pelvic tilt, flexible ruler for lumbar angle. An informed consent will be taken. Subjects will be selected on the basis of inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. Group A will receive Sahrmann's exercise protocol while group B will receive Janda's Approach. Both groups will receive 10 mins heating pad and 10 mins Tens for muscle relaxation. Outcome measures will be measured at baseline and then at 4th week. Data Analysis will be done by IBM SPSS version 21.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sahrmann's approach | Experimental | Dr. Shirley Sahrmann's approach-rooted in her concept of Movement System Impairment (MSI) Syndromes-takes a functional, movement-based approach to postural dysfunctions like lower crossed syndrome (LCS). Rather than treating LCS strictly as a static structural cross-syndrome, her model emphasizes analyzing how the body moves in daily life |
|
| Janda Approach | Active Comparator | The Janda approach to Lower Crossed Syndrome (LCS) corrects muscle imbalances caused by prolonged sitting or poor posture. It targets an alternating "cross" of tight and weak muscles-specifically tight hip flexors/lower back muscles and weak glutes/abdominals-to relieve low back pain and restore proper pelvic alignment. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sahrmann's approach | Other |
1.Clamshell (side lying) strengthening of gluteus medius 2.Hip abduction gluteus medius strengthening 3.Extension of femur 4.isometric abdominal contraction(top to floor) 5. abdominal contraction(cat exercise) |
| Measure | Description | Time Frame |
|---|---|---|
| Numeric pain rate scale (NPRS) for pain | The Numeric Pain Rating Scale (NRS) is an 11-point, standardized assessment tool used to measure subjective pain intensity. Ranging from 0 ("no pain") to 10 ("the worst pain imaginable"), it provides healthcare providers with a quick and reliable method to evaluate pain severity, track symptom changes, and measure treatment effectiveness | upto 4 weeks |
| Flexible Ruler for lumbar Lordosis (degree) | To measure lumbar lordosis using a flexible ruler (flexicurve), mold it to the curvature of your spine from T12 to S2. Trace the curve onto paper to find the curve's length (\(L\)) and the maximum perpendicular height (\(H\)). Calculate the angle in degrees using the equation: \(\theta = 4 \times \arctan(2H/L)\). | upto 4 weeks |
| I Handy Level for Pelvic tilt(degree) | The examiner performed the process three times, and during those three trials, the best view was acquired, the normal average anterior pelvic tilt angle is 9.6±3.5 and 11.7±3.8° in males and females, respectively | upto 4 weeks |
Not provided
Not provided
Inclusion Criteria:
• Gender (both)
Exclusion Criteria:
• Any serious pathology i.e. Neoplasm
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Samrood Akram, PhD* | Contact | 03324806143 | samrood.akram@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Samrood Akram, PhD* | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rasheed Hospital | Lahore | Punjab Province | 54000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Kandil EA, Yamany AAER, Alsaka SSD, Abd El-Azeim AS. Effect of global postural reeducation on chronic low pain patients with lower cross syndrome. Bulletin of Faculty of Physical Therapy. 2024;29(1):8. | ||
| 39166267 | Background | Sugavanam T, Sannasi R, Anand PA, Ashwin Javia P. Postural asymmetry in low back pain - a systematic review and meta-analysis of observational studies. Disabil Rehabil. 2025 Apr;47(7):1659-1676. doi: 10.1080/09638288.2024.2385070. Epub 2024 Aug 21. | |
| Background | Nourbakhsh MR, Arabloo AM, Salavati M. The relationship between pelvic cross syndrome and chronic low back pain. Journal of Back and Musculoskeletal Rehabilitation. 2006;19(4):119-28. | ||
| Background | Pradeep S, Heggannavar A, Metgud S. Effect of Sciatic Nerve Neurodynamic Sustained Natural Apophyseal Glides on Individuals with Pelvic Crossed Syndrome: A Randomized Controlled Trial. Indian Journal of Physical Therapy and Research. 2020;2(1):35-40. |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
| Jandas approach | Other | 1.50 to 70 degrees of trunk flexion 2.Pelvis tilting 3.One leg standing 4.Quadreped position (forward and backward movement) 5. Quadruped position (raising opposite arm and leg) 6. pelvic bridging 7.One leg bridge 8.Side Plank 9.Abdominal bracing 10. Knee active bending 90 degrees 11. Half Crunch |
|
| Background | Puagprakong P, Earde P, Kooncumchoo P, editors. Lumbo-Pelvic-Hip Angle Changes During Upright and Free Style Sitting in Office Workers with Lower Crossed Syndrome. Human Interaction, Emerging Technologies and Future Applications IV; 2021 2021//; Cham: Springer International Publishing. |
| 15928561 | Background | Childs JD, Piva SR, Fritz JM. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine (Phila Pa 1976). 2005 Jun 1;30(11):1331-4. doi: 10.1097/01.brs.0000164099.92112.29. |
| Background | Seidi F, Rajabi R, Ts E, Sj M. Iranian Flexible ruler Reliability and Validity in Lumbar Lordosis Measurement. World Journal of Sport Sciences. 2009;2:95-9. |
| 37241022 | Background | Lewandrowski KU, Elfar JC, Li ZM, Burkhardt BW, Lorio MP, Winkler PA, Oertel JM, Telfeian AE, Dowling A, Vargas RAA, Ramina R, Abraham I, Assefi M, Yang H, Zhang X, Ramirez Leon JF, Fiorelli RKA, Pereira MG, de Carvalho PST, Defino H, Moyano J, Lim KT, Kim HS, Montemurro N, Yeung A, Novellino P. The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States. J Pers Med. 2023 May 18;13(5):852. doi: 10.3390/jpm13050852. |
| Background | Luna, A., Casertano, L., Timmerberg, J., O'Neil, M., Machowsky, J., Leu, C.-S., . . . Agrawal, S. (2021). Artificial intelligence application versus physical therapist for squat evaluation: a randomized controlled trial. Scientific Reports, 11(1), 18109. doi:10.1038/s41598-021-97343-y Mahmoud, H., Aljaldi, F., El-Fiky, A., Battecha, K., Thabet, A., Alayat, M., . . . Ibrahim, A. (2023). Artificial Intelligence machine learning and conventional physical therapy for upper limb outcome in patients with stroke: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci, 27(11), 4812-4827. doi:10.26355/eurrev_202306_32598 |