Positional Release Technique Versus Stretching Exercises In Patients With Chronic Non-Specific Low Back Pain

NCT ID: NCT07026071

Last Updated: 2025-07-07

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-05-01
• Study Completion Date: 2025-09-30

Brief Summary

This study will be a Randomized Clinical Trial and will be conducted in Physiotherapy Outpatient Department of Allama Iqbal Memorial Teaching Hospital, Sialkot. Non-Probability Convenient Sampling will be used to collect the data. Sample size of subjects with age group between 18-45 years will be taken. Data will be collected from the patients having present complaint of Chronic Non-Specific Low Back Pain. Outcome measures will be taken using Numeric pain rating scale (NPRS) for pain, Oswestry Disability Index for Disability and Inclinometer for Range of motion. An informed consent will be taken from the participants. 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. Both the Groups will receive Transcutaneous Electrical Nerve Stimulation, Hot Pack, and Standard Physical Therapy exercises for CNSLBP, while Group A will receive Positional Release Technique for Iliopsoas, Quadratus Lumborum and Hamstring Muscle and Group B will receive Stretching Exercises of Iliopsoas, Quadratus Lumborum and Hamstring Muscle. Outcome measures will be measured at baseline and after 4 weeks. Data analysis will be done by SPSS version 25.

Detailed Description

Low back pain (LBP) is considered one of the most prevalent and debilitating musculoskeletal conditions that affects the majority of the general population. It is the most commonly reported complaint area in musculoskeletal conditions, leading to pain and a reduction in overall life quality. Low back pain is pain in the region between the 12th rib and the inferior gluteal fold and is a musculoskeletal system problem that is common in society, mostly caused by nonspecific causes and leads to disability.

Low Back Pain is present in developed countries as well as developing ones, but presents different issues in both: in developed countries, the impact and burden of Non-Specific Low Back Pain is placed on the healthcare and social system first. In contrast, in developing countries, the burden is predominantly placed on the people impacted by low back pain and their support systems.

Nonspecific low back pain is defined as the pain where no specific pathoanatomical cause can be identified and is the most common type of low back pain. A total of 90% of low back pain lacks identifiable pathology and is termed 'non-specific' low back pain (NSLBP). Depending on the duration of the pain, acute low back pain is defined as the pain persisting for less than 06 weeks, Sub-acute Non Specific Low Back Pain refers to pain that lasts between six weeks and three months and chronic non-specific low back pain is the pain when it lasts for more than 12 weeks. Low back pain often becomes chronic, and if non-specific low back pain lasts more than 3 months, it is called chronic non-specific low back pain. Many people with low back pain will experience resolution within 6 weeks of onset. However, two-thirds of people with low back pain report pain at 3 months and 12 months.

Chronic Low Back Pain is a widespread issue that affects many people's daily lives and work abilities. This research compares the Positional Release Technique and Stretching Exercises with standard physical therapy to see which treatment better reduces pain, improves range of motion and decreases disability. The goal of this research is to provide physical therapists with clear evidence on the most effective treatment for CNSLBP, focusing on Iliopsoas, Quadratus Lumborum and Hamstrings Muscle. By identifying the best techniques, this study aims to equip physical therapists with new methods to enhance patient care which, in turn, will aid the healthcare system in providing more effective care.

Conditions

Low Back Pain

Study Design

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

Study Groups

Group A

Group Type: EXPERIMENTAL

Positional Release Technique

Intervention Type: OTHER

Positional Release Technique will be repeated 3 times in each session for each muscle with an aim to produce a decrease in perceived pain and an increase in pressure tolerance Iliopsoas Quadratus Lumborum Hamstrings

Group B

Group Type: ACTIVE_COMPARATOR

Stretching Exercises

Intervention Type: OTHER

These exercises will be performed with three repetitions per set, three sets per visit and with 30 seconds hold and 30 seconds rest Iliopsoas Quadratus Lumborum Hamstrings

Interventions

Positional Release Technique

Positional Release Technique will be repeated 3 times in each session for each muscle with an aim to produce a decrease in perceived pain and an increase in pressure tolerance Iliopsoas Quadratus Lumborum Hamstrings

Intervention Type: OTHER

Stretching Exercises

These exercises will be performed with three repetitions per set, three sets per visit and with 30 seconds hold and 30 seconds rest Iliopsoas Quadratus Lumborum Hamstrings

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Male or Female Gender
• 18 - 45 years of age
• Back Pain with the duration longer than 12 weeks.
• Numeric Rating Scale (NRS) score of 3-7/10
• Oswestry Disability Index score of 20-60
• Minimum 20 degrees of flexion at knee while performing active knee extension test
• Positive Modified Thomas Test
• Participations with Lumbar Pain and Pain in the attachments of Quadratus Lumborum Muscle (iliac crest and lower ribs) or pain localized para spinally or restriction in motion of lumbar due to tightness of Quadratus Lumborum Muscle

Exclusion Criteria

• Serious spinal disorders, such as fractures
• History of trauma or Previous Spinal Surgery
• Spine osteoarthritis, Spinal Canal Stenosis and Spondylolistheses
• Any neurological symptoms involving Prolapsed Intervertebral Disc, Radiculopathy or presence of root symptoms (e.g. Sciatica and Cauda Equina Syndrome)
• Any systemic disease like Rheumatoid Arthritis, Ankylosing Spondylitis
• Pregnancy, Cancer or Malignancy
• Altered Sensation and Deep Tendon Reflex

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 45 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Syed Shakil ur Rehman, PhD

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

Riphah Rehabilitation Clinic

Lahore, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

Syed Shakil ur Rehman, PhD

Role: CONTACT

shakil.urrehman@riphah.edu.pk

+92 320 786661

Facility Contacts

Syed Shakil ur Rehman, PhD

Role: primary

shakil.urrehman@riphah.edu.pk

+92 320 7866611

References

Sheeran L, Al-Amri M, Sparkes V, Davies JL. Assessment of Spinal and Pelvic Kinematics Using Inertial Measurement Units in Clinical Subgroups of Persistent Non-Specific Low Back Pain. Sensors (Basel). 2024 Mar 26;24(7):2127. doi: 10.3390/s24072127.

Reference Type: BACKGROUND

PMID: 38610338 (View on PubMed)

Robinault L, Niazi IK, Kumari N, Amjad I, Menard V, Haavik H. Non-Specific Low Back Pain: An Inductive Exploratory Analysis through Factor Analysis and Deep Learning for Better Clustering. Brain Sci. 2023 Jun 13;13(6):946. doi: 10.3390/brainsci13060946.

Reference Type: BACKGROUND

PMID: 37371424 (View on PubMed)

Vatovec R, Voglar M. Changes of trunk muscle stiffness in individuals with low back pain: a systematic review with meta-analysis. BMC Musculoskelet Disord. 2024 Feb 19;25(1):155. doi: 10.1186/s12891-024-07241-3.

Reference Type: BACKGROUND

PMID: 38373986 (View on PubMed)

Other Identifiers

Burhan- REC/RCR&AHS 24/0140

Identifier Type: -

Identifier Source: org_study_id