Comparison of Post Facilitation Stretch Versus Reciprocal Inhibition in Quadratus Lumborum Syndrome: a Randomized Controlled Trial

NCT ID: NCT06534853

Last Updated: 2024-08-02

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 42 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-09-01
• Study Completion Date: 2025-01-30

Brief Summary

This study is a randomised control trial and the purpose of this study is to determine the effects Post facilitation stretch versus reciprocal inhibition on pain, lumbar range of motion, apparent leg length discrepancy and lumbar lordotic angle in Quadratus Lumborum Syndrome.

Detailed Description

The purpose of this study is to determine the difference between Post facilitation, stretch versus reciprocal inhibition on pain, lumbar range of motion, apparent leg length discrepancy and lumber lordotic angle in Quadratus Lumborum Syndrome.

The individual of Age 18-35 years among both genders, who experiences pain of 3 ≤ on NPRS from at least 3 months and whose pain decreases on supine lying; along with any two of the following findings positive of quadratus lumborum on physical examination i.e., Taut bands, Local tenderness, Patient's pain recognition, Pain referral to greater trochanter, Local twitch response & Jump sign will be recruited in the study as patients of Quadratus lumborum syndrome.

Pain levels will be assessed using the Numeric Pain Rating Scale (NPRS). Inclinometer will be used for measuring lumber ranges. To assess apparent leg length discrepancy measuring tape will be used. The lumbar lordotic angle will be measured using 60 cm flexible ruler. Participants of interest would be approached and explained about the research. Informed written consent will be taken. It is a non-blinded study and randomization will be done through sealed envelope. Both groups will receive conventional intervention. Additionally, Group A will receive quadratus lumborum post facilitation stretches while Group B will receive Reciprocal inhibition. Baseline and post intervention scores would be recorded for both groups.

Conditions

Quadratus Lumborum Syndrome

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

PFS Group

Group A along with Post facilitation stretch of quadratus lumborum will a comprehensive therapeutic regimen that includes a 10-minute session of hot pack therapy specifically targeted at the low back region. In addition to this, participants will receive trigger point release therapy to alleviate muscle tension. The treatment plan also incorporates a tailored exercise protocol designed to enhance back health and strength. This protocol includes:

1. Back isometric exercises

2. Bridging exercises

3. Cat and camel stretches

4. Prone press-ups

5. Abductor strengthening exercises

Group Type: EXPERIMENTAL

Post Facilitation Stretch

Intervention Type: OTHER

The patient is placed in the lateral decubitus position with the affected side up and a Dutchman's roll or pillow under the iliac crest. Positioned at the edge of the table, the patient's inferior leg is flexed with the foot at the table's edge. The patient grasps the headpiece of the table with the superior hand, allowing the superior leg to drop off the back of the table.The therapist stands behind the patient, providing support to prevent posterior pelvic rotation with their thigh behind the pelvis. The cephalad hand grasps the top of the iliac crest and applies a caudad force, while the caudad hand gently guides the affected leg without generating force.The patient "hikes" the hip against the resistance from the therapist's cephalad hand, creating an isometric contraction for 5-10 seconds. The patient then relaxes, followed by a rapid stretch held for 10 seconds until the next barrier is reached. This procedure is repeated 3-5 times.

Conventional Physical Therapy

Intervention Type: OTHER

A comprehensive therapeutic regimen that includes a 10-minute session of hot pack therapy specifically targeted at the low back region. In addition to this, participants will receive trigger point release therapy to alleviate muscle tension.The treatment plan also incorporates a tailored exercise protocol designed to enhance back health and strength. This protocol includes:

1. Back isometric exercises

2. Bridging exercises

3. Cat and camel stretches

4. Prone press-ups

5. Abductor strengthening exercises

RI Group

Group B along with Reciprocal inhibition of quadratus lumborum will a comprehensive therapeutic regimen that includes a 10-minute session of hot pack therapy specifically targeted at the low back region. In addition to this, participants will receive trigger point release therapy to alleviate muscle tension. The treatment plan also incorporates a tailored exercise protocol designed to enhance back health and strength. This protocol includes:

1. Back isometric exercises

2. Bridging exercises

3. Cat and camel stretches

4. Prone press-ups

5. Abductor strengthening exercises

Group Type: EXPERIMENTAL

Reciprocal Inhibition

Intervention Type: OTHER

The patient is placed in the lateral decubitus position with the affected side up and a Dutchman's roll or pillow under the iliac crest. Positioned at the edge of the table, the patient's inferior leg is flexed with the foot at the table's edge. The patient grasps the headpiece of the table with the superior hand, allowing the superior leg to drop off the back of the table.The therapist stands behind the patient, providing support to prevent posterior pelvic rotation with their thigh behind the pelvis. The cephalad hand grasps the top of the iliac crest and applies a caudad force, while the caudad hand gently guides the affected leg without generating force.The patient "hikes" the hip against the resistance from the therapist's cephalad hand, creating an isometric contraction for 5-10 seconds. The patient then relaxes, followed by a rapid stretch held for 10 seconds until the next barrier is reached. This procedure is repeated 3-5 times.

Conventional Physical Therapy

Intervention Type: OTHER

A comprehensive therapeutic regimen that includes a 10-minute session of hot pack therapy specifically targeted at the low back region. In addition to this, participants will receive trigger point release therapy to alleviate muscle tension.The treatment plan also incorporates a tailored exercise protocol designed to enhance back health and strength. This protocol includes:

1. Back isometric exercises

2. Bridging exercises

3. Cat and camel stretches

4. Prone press-ups

5. Abductor strengthening exercises

Interventions

Post Facilitation Stretch

The patient is placed in the lateral decubitus position with the affected side up and a Dutchman's roll or pillow under the iliac crest. Positioned at the edge of the table, the patient's inferior leg is flexed with the foot at the table's edge. The patient grasps the headpiece of the table with the superior hand, allowing the superior leg to drop off the back of the table.The therapist stands behind the patient, providing support to prevent posterior pelvic rotation with their thigh behind the pelvis. The cephalad hand grasps the top of the iliac crest and applies a caudad force, while the caudad hand gently guides the affected leg without generating force.The patient "hikes" the hip against the resistance from the therapist's cephalad hand, creating an isometric contraction for 5-10 seconds. The patient then relaxes, followed by a rapid stretch held for 10 seconds until the next barrier is reached. This procedure is repeated 3-5 times.

Intervention Type: OTHER

Reciprocal Inhibition

The patient is placed in the lateral decubitus position with the affected side up and a Dutchman's roll or pillow under the iliac crest. Positioned at the edge of the table, the patient's inferior leg is flexed with the foot at the table's edge. The patient grasps the headpiece of the table with the superior hand, allowing the superior leg to drop off the back of the table.The therapist stands behind the patient, providing support to prevent posterior pelvic rotation with their thigh behind the pelvis. The cephalad hand grasps the top of the iliac crest and applies a caudad force, while the caudad hand gently guides the affected leg without generating force.The patient "hikes" the hip against the resistance from the therapist's cephalad hand, creating an isometric contraction for 5-10 seconds. The patient then relaxes, followed by a rapid stretch held for 10 seconds until the next barrier is reached. This procedure is repeated 3-5 times.

Intervention Type: OTHER

Conventional Physical Therapy

A comprehensive therapeutic regimen that includes a 10-minute session of hot pack therapy specifically targeted at the low back region. In addition to this, participants will receive trigger point release therapy to alleviate muscle tension.The treatment plan also incorporates a tailored exercise protocol designed to enhance back health and strength. This protocol includes:

1. Back isometric exercises

2. Bridging exercises

3. Cat and camel stretches

4. Prone press-ups

5. Abductor strengthening exercises

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age 18-35 years
• Both genders
• Having pain of ≤ 8 on NPRS from at least 3 months
• Pain decreases on supine lying
• Any two of the following findings positive of unilateral quadratus lumborum on physical examination:

1. Taut bands

2. Local tenderness

3. Patient's pain recognition

4. Pain referral to greater trochanter

5. Local twitch response

Exclusion Criteria

• Painful isometric muscle testing of hip flexors, abductors, adductors, and extensors
• Previous surgery of lower limb
• Centralization/peripheralization
• Lower back trauma
• Positive SLR
• Radiculopathy
• Fracture/surgery of pelvic and/or hip region
• Diagnosed fibromyalgia or other rheumatic diseases.
• Lactating women
• Intrauterine device
• Pregnant women
• Use of psychiatric medications

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 35 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Foundation University Islamabad

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Foundation University College of Physical Therapy

Rawalpindi, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

Aqsa Ayaz, MS-MSKPT*

Role: CONTACT

aqsaayaz77@gmail.com

03365765782

Facility Contacts

Qurat ul Ain Saeed, MS-OMPT,PHD*

Role: primary

quratulain.saeed@fui.edu.pk

03315562889

Other Identifiers

FUI/CTR/2024/22

Identifier Type: -

Identifier Source: org_study_id