The aim of this randomized clinical trial is to find the comparison of Short foot exercises and anti-pronation taping on low back pain associated with hyper pronation on reducing back pain improving range of motion of foot, back and foot posture.
Low back pain is a musculoskeletal symptom which occur in all ages during life time with acute episode or chronic condition. Total of 619 million people are living with low back pain worldwide. Low back pain is the musculoskeletal condition that involves pain in region below costal margin and above inferior gluteal fold, along with pain there is also stiffness, limitation of range of motion, aggravated by movement and affected ability to perform daily life activities. Frequency and severity of low back pain are related to spinal loading that increase the strain on lumbar spine, these loads shift from foot (during heel strike) to leg and ultimately to the back. Abnormal mechanical loading of lumbar spine due to poor postural control or muscular weakness is considered as risk factor for low back pain. The ability of ankle complex to provide stabilization and mobilization depends upon plantar pressure distribution. In particular, pronated foot causes internal rotation of tibia along with internal rotation of hip that cause femoral ante-version and increase in lumbar lordosis and deteriorate lumbopelvic alignment resulting in low back pain Short foot exercise (SFE) is considered more effective in terms of postural balance and excessive pronation. SFE is a widely used intervention that has been developed recently to improve ankle proprioception and global movement pattern, so as to elevate and support the medial longitudinal arch of the foot and to improve dynamic standing balance Anti-pronation taping is a technique that stimulate underlying sensory receptor either through the surface contact or stretch of skin that causes the sensory input to central nervous system to be altered hence it ultimately influences the execution and perception of movement. Low dye taping is effective in correcting over-pronated foot and also increase navicular height along with increase in reactive strength index. low dye taping not only improve arch height but also improves muscular activity The rationale for the use of these techniques is to compare the effect of short foot exercises and anti-pronation taping on low back pain associated with hyper-pronated foot and also on range of motion of foot and back along with the foot posture.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
They would be receiving treatment as follow: Anti-pronation taping (Low dye taping) Applied on alternate days. 3 days / week for 4 weeks. Conventional Therapy includes 1. Tens biphasic mode, 90Hz, 100ms pulse width for 20 mins 2. William flexion exercises (5repsx1set). 3. Lower limb stretching exercises (3repsxset1, 10sec hold) 3sessions/ week.
They would be receiving treatment as follow: Short foot exercises are used to reduce the foot pronation: Frequency: 30 reps x 1 set, 30 sec hold and 10 sec relaxation for 4 weeks. 3 session/ week). Short foot Exercises includes a four-week plan, 1- Shortening of foot in Anterior-posterior direction, 2- Increase medial longitudinal arch, 3- Balanced loading in standing, 4- Approximating Head of first, second meta-tarsal and calcaneus with patient in standing (single leg). Conventional therapy includes 1. Tens biphasic mode, 90Hz, 100ms pulse width for 20 mins 2. William flexion exercises (5repsx1set). 3. Lower limb stretching exercises (3repsx1set, 10sec hold) 3sessions/ week.
Rawal Surgical Hospital, Nawababad, Wah Cantt
Wāh, Punjab Province, Pakistan
RECRUITINGRange of motion (Goniometer)
It is a tool used to measure the range of motion of joint (0-180). Record the starting measurement, remove the goniometer, and allow the patient to move the joint through the available range of motion. Replace and realign the goniometer. Read and record the measurement.
Time frame: 4 weeks
Numeric Pain Rating Scale NPRS
The NPRS is an eleven-point pain impression scale: the patient rates pain from 0 (no aggravation) to 10 (most exceedingly terrible possible pain). Numeric Pain Rating Scale (NPRS), which was used to survey respondents' impression of the degree of pain that they felt. NPRS has been utilized in different examinations for low back pain.
Time frame: 4 weeks
Foot Posture Index
It is a tool which provides quantitative data about foot posture. It has total six items. Talar head palpation, observation of curves above and below the lateral malleolus, a bulge in the region of the talonavicular joint, eversion and inversion of the calcaneus, congruence of the medial longitudinal arch, adduction and abduction of the forefoot in relation to the rear foot. Total score between (- 12 and + 12). (0 and + 5 normal feet) ;( + 6 to + 9 pronated feet) ;( ≥ + 10 highly pronated feet) ;( - 1 to - 4 supinated feet); - 5 to - 12 indicate highly supinated.
Time frame: 4 weeks
Oswestry Disability Index
The ODQ scale was utilized to quantify the limitations in regular daily life activities. It depends on 10 segments with six levels each, evaluating the restriction of different activities of day to day living. The qualities range from 0 (the best wellbeing state) to 100 (the most worsening wellbeing state). For each segment of the poll, the absolute plausible score is 5.
Time frame: 4 weeks
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