Effects Of Jandas Approach Vs PNF Technique On Pain, ROM, Disability, Endurance And QOL In Patients With LCS

NCT ID: NCT06737900

Last Updated: 2024-12-17

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 52 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-07-01
• Study Completion Date: 2025-01-31

Brief Summary

The goal of this randomized clinical trial is to learn if the given interventions that is jandas approach versus Proprioceptive Neuromuscular Facilitation technique can treat pain, disability, range of motion, endurance and quality of life in patients with Lower cross syndrome on both genders and age group of 25-40 years. The main questions it aims to answer are:

Does jandas approach versus Proprioceptive neuromuscular facilitation technique improves pain, disability, range of motion, endurance and quality of life in patients with lower cross syndrome?

There is a comparison between two groups: Researchers will compare the jandas approach and proprioceptive neuromuscular facilitation technique to see if there is effects on pain, disability, range of motion, endurance and quality of life in patients with lower cross syndrome.

Participants in group A will be given

• Heating pad for 10 minutes
• Core stability exercises for 20 minutes with 10 seconds of rest intervals
• Proprioceptive Neuromuscular Facilitation technique was used for stretching of erector spinae, quadratus lumborum, rectus femoris and iliopsoas and rhythmic stabilization technique for strengthening. Stretching was performed using contract-relax technique in supine, prone and side lying positions. The Contract-Relax method included the target muscle to be lengthened and held in lengthened position while the patient contracted the Target-Muscle to its maximum position isometrically 3 to 6 seconds.
• Rhythmic stabilization technique was used to strengthen and stabilize the postural trunk muscles of hip: Abdominals and gluteal muscles strengthening and Participants in group B will be given
• Heating pad for 10 minutes
• Core stability exercises for another 20 minutes.
• After which it was treated with the Janda's approach of musculoskeletal pain that includes strengthening of the weakened muscles and stretching of the tightened muscles including Stretching exercise for erector spinae and back extensors muscles Stretching exercises for iliopsoas muscle and rectus femoris muscle Strengthening exercise for abdominal muscle and gluteal maximus muscle

Detailed Description

A Randomized Clinical Trial was conducted at Riphah Clinic Lahore. A total of 52 patients (N=52) were assessed for eligibility criteria through non-probability consecutive sampling technique. 6 participants were excluded from the research. These 6 patients rejected to be the part of the study and declined any treatment. Hence 46 participants were included in the study that were first assessed and diagnosed with lower cross syndrome and met the inclusion criteria. As a result, total of 46 patients including (females: 39, males: 7) were considered eligible for the study. They were randomized through computer generated software. The list was concealed by a sealed envelope. The group A was labeled as 1 and group B was labeled as 2. Patients enrolled in this study have age between 25-40 years. Consent form was filled before the start of the treatment. The participants were randomly enrolled into two groups named as group A and group B. Baseline assessment of pain, disability, quality of life, lumbar range of motion, hip range of motion and endurance was taken using NPRS, ODI, SF-36, inclinometer, goniometer and McGill test of endurance respectively, before the start of the treatment by an assessor. Both groups: A and B received baseline treatment that consisted of a heating pad for 10 minutes followed by core stability exercises for 20 minutes with 10 seconds of rest intervals. Patients were advised to stretch for 5 minutes then perform lumber stability exercises.

Group A The group A first received the baseline treatment mentioned above then Proprioceptive Neuromuscular Facilitation technique for stretching and rhythmic stabilization technique for strengthening. PNF stretching was performed using contract-relax technique in supine, prone and side lying positions. The Contract-Relax method includes the target muscle to be lengthened and held in lengthened position while the patient will contract the Target-Muscle to its maximum position isometrically for an allotted amount of time that varies from 3 to 6 seconds. The muscle which is contracting is the agonist and the muscle which is relaxing is called the antagonist.

• Erector spinae stretching: Ask the patient to lie down and bring both the legs up to their chest by grabbing around their knees to stretch erector spinae muscle. Ask the patient to tuck in their chin and hold the stretch for 6 seconds of contraction with 80% force of the maximal isometric contraction on the erector spinae followed by a 15-second passive static stretching in the opposite direction of the muscle.

Quadratus lumborum stretching: the patient will perform active lateral flexion of the spine. To stretch the right QL the patient will laterally flex the spine to the left and vice versa. Ask the patient to hold the lateral flexion for 6 seconds of contraction with 80% force on the of the maximal isometric contraction on the muscle followed by a 15-second passive static stretching in the opposite direction of the muscle.

Rectus femoris stretching: the patient will lie in a side lying position on the treatment couch. The patient will flex the uppermost testing knee backwards and the therapist will hold onto above the foot of the patient, bend the knee to 90 degree and will pull the hip into extension and will ask the patient to hold a 6 second contraction with 80% force of the maximal isometric contraction of muscle followed by a 15-second passive static stretching in the opposite direction of the muscle.

Iliopsoas stretching: by using the modified Thomas test position, the patient will lie supine on the treatment table. Ask the patient to hold the unaffected leg towards their chest, the therapist will then hold the leg to be stretched above the knee and will provide a constant force to stretch and extend the leg. The contractions will be held for 6 seconds with 80% force of the maximal isometric contraction of muscle followed by a 15-second passive static stretching in the opposite direction of the muscle Rhythmic stabilization technique; is also a PNF technique that is shown to strengthen and stabilize the postural trunk muscles of hip and shoulder girdle. Therefore it will be used for the strengthening of the abdominal muscles and the gluteal muscles.

• Abdominals and gluteal muscles strengthening: Ask the patient to lie on the mat with both the knees flexed. The patient will raise their hips and perform a glute hold for 2 to 5 seconds against the resistance applied by the therapist. Hip rolls can also be performed by the patient in each direction against the resistance applied by the therapist.

Group B: The group B received heating pad for 10 minutes and core stability exercises for another 20 minutes after which it was treated with the Janda's approach of musculoskeletal pain that includes strengthening of the weakened muscles and stretching of the tightened muscles. This approach included:

• Stretching exercise for erector spinae and back extensors muscles
• Stretching exercises for iliopsoas muscle and rectus femoris muscle
• Strengthening exercise for abdominal muscle and gluteal maximus muscle. Stretching exercise will be performed actively for 30 second hold and 3 repetitions.

Strengthening exercise will be performed for 10 second hold and 10 repetitions. All Exercise will be performed 3 times per week for total of 4 weeks

Conditions

Lower Cross Syndrome

Keywords

Disability, Muscle strength, Pain, Quality of life, range of motion

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

traditional physical therapy

Heating pad for 10 minutes and Core stability exercises for 20 minutes with 10 seconds of rest intervals.

Group Type: ACTIVE_COMPARATOR

jandas approach

Intervention Type: OTHER

• Stretching exercise for erector spinae and back extensors muscles
• Stretching exercises for iliopsoas muscle and rectus femoris muscle
• Strengthening exercise for abdominal muscle and gluteal maximus muscle Stretching exercise was performed actively for 3 repetitions x 1 set and 4 days a week Strengthening exercise was performed for 10 second hold and 10 repetitions. All Exercises was performed 3 times per week for total of 4 weeks

Proprioceptive Neuromuscular Facilitation technique

Heating pad for 10 minutes and core stability exercises for 20 minutes along with Proprioceptive Neuromuscular Facilitation technique was used for stretching and rhythmic stabilization technique for strengthening. Stretching was performed using contract-relax technique.

Group Type: EXPERIMENTAL

traditional physical therapy

Intervention Type: OTHER

• Heating pad for 10 minutes
• Core stability exercises for 20 minutes with 10 seconds of rest intervals
• Patients were advised to stretch for 5 minutes then perform lumber stability exercises.
• These stability exercises included side bridges, supine extension bridge, straight leg raise in prone lying, alternate arm and leg raise from quadruped position and prone bridges.

Both groups took sessions thrice a week for a total of 4 weeks.

Interventions

traditional physical therapy

• Heating pad for 10 minutes
• Core stability exercises for 20 minutes with 10 seconds of rest intervals
• Patients were advised to stretch for 5 minutes then perform lumber stability exercises.
• These stability exercises included side bridges, supine extension bridge, straight leg raise in prone lying, alternate arm and leg raise from quadruped position and prone bridges.

Both groups took sessions thrice a week for a total of 4 weeks.

Intervention Type: OTHER

jandas approach

• Stretching exercise for erector spinae and back extensors muscles
• Stretching exercises for iliopsoas muscle and rectus femoris muscle
• Strengthening exercise for abdominal muscle and gluteal maximus muscle Stretching exercise was performed actively for 3 repetitions x 1 set and 4 days a week Strengthening exercise was performed for 10 second hold and 10 repetitions. All Exercises was performed 3 times per week for total of 4 weeks

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age group of 25-40 years.
• Both genders male and female.
• NPRS score range from 4-7.
• Modified Thomas test positive , Back extensor test positive, prone hip extension strength test positive , Trunk flexion strength test positive.

Exclusion Criteria

• Vertebral Fractures
• Tumors
• Pregnancy
• Diagnosed psychological disorders

• Minimum Eligible Age: 25 Years
• Maximum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Amna Shahid, t-DPT

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

Riphah Rehab Training and Research Center

Lahore, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

Imran Amjad, Phd

Role: CONTACT

Phone: 03324390125

Email: imran.amjad@riphah.edu.pk

Facility Contacts

Dr. Ali Raza

Role: primary

References

1) authors: rajalaxmi v, nandhini g etc, article name: efficacy of jandas approach versus brueggers exercise in pelvic cross syndrome and its impact on quality of life, journal name: JK welfare and pharmascope foundation, publication date: 8 feb 2020, volume and pages were not mentioned

Reference Type: BACKGROUND

Other Identifiers

REC/RCR&AHS/24/0107

Identifier Type: -

Identifier Source: org_study_id