Comparison of Positional Release and Manual Pressure Technique in Chronic Low Back Pain

Chronic Low-back Pain Clinical Trial

Official title:

Comparative Effects of Positional Release and Manual Pressure Techniques of Tight Hip Flexors on Pain, Range of Motion, Lumbosacral Angle, and Disability in Patients With Chronic Low Back Pain

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06240949
• Other study ID #: REC/RCR & AHs/23/0168
• Status: Recruiting
• Phase: N/A
• Start date: November 5, 2023
• Est. completion date: February 5, 2024

Study information

• Verified date: January 2024
• Source: Riphah International University
• Contact: Imran Amjad, phD
• Phone: 03324390125
• Email: imran.amjad[@]riphah.edu.pk
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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

Description:

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.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 46
• Est. completion date: February 5, 2024
• Est. primary completion date: February 5, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 25 Years to 40 Years

Eligibility

Inclusion Criteria:

• Males and females

• age group 25 to 40yrs

• Atraumatic chronic low back pain more than 3 months

• Patients with Anterior pelvic tilt

• Patients with lumbosacral angle > than 50 degrees

Exclusion Criteria:

• Pregnancy

• history of vertebral fracture

• History of any spinal surgery

• Disc disease

• Osteoporosis

• Bone disease

• Patient unable to give consent

Related Conditions & MeSH terms

• Back Pain
• Chronic Low-back Pain
• Low Back Pain

Intervention

Device:
• Positional Release Technique
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.
• Manual Pressure Technique
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.

Locations

Country	Name	City	State
Pakistan	DHQ and tertiary hospitals	Khanewal

Sponsors (1)

Lead Sponsor	Collaborator
Riphah International University

Country where clinical trial is conducted

Pakistan, 

References & Publications (15)

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. Erratum In: Int J Sports Phys Ther. 2019 Apr;14(2):173. — View Citation

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. — View Citation

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.

Chaitow L. Positional Release Techniques E-Book: Elsevier health sciences; 2007

Deyo RA, Von Korff M, Duhrkoop D. Opioids for low back pain. BMJ. 2015 Jan 5;350:g6380. doi: 10.1136/bmj.g6380. — View Citation

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. — View Citation

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. — View Citation

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. — View Citation

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

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. — View Citation

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. — View Citation

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. — View Citation

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

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

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. — View Citation

* Note: There are 15 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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
Primary	Pain Intensity	Pain intensity will be evaluated using the Numeric Pain Rating Scale (NPRS)	4th week
Primary	Functional disability	Functional disability will be assessed by Oswestry disability questionnaire.	4th week
Primary	Anterior pelvic tilt	Anterior pelvic tilt will be measured using an inclinometer	4th week