Effect of Mulligan Technique Versus Core Stability Exercises on Low Back Pain in Post Menopausal Women

N/ANot Yet RecruitingNCT06634550

Cairo University60 enrolled

Overview

This study will be conducted to compare the effect of Mulligan technique and core stability exercises on low back pain in post menopausal women.

Low back pain is a major health problem affecting majority of the people at some point of their life. Mulligan techniques can correct positional faults that occur in the spine and, thus, once the pain generator is released, normal function returns and the muscle guarding around the affected joint is resolved. Several studies have reported that along with the biomechanical changes, certain neurophysiological changes exist that occur at the spinal level after applying Mulligan techniques, including changes in descending pain inhibitory systems and changes in central pain processing mechanisms. Core stability exercises are usually used to strengthen the muscles around the abdominal, lumbar, and pelvic regions, because the muscles of these regions play an important role in stability as well as in controlling the lumbar posture by using tonic or postural muscles during whole-body exercises. So, this study will be conducted to provide new evidence and information about the efficacy of Mulligan technique versus core stability exercises on low back pain in postmenopausal women, to manage this problem for these women and add new information to the field of physical therapy.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Low Back Pain

Interventions

Mulligan techniqueOTHER

The participants will receive Mulligan technique (modified SNAGs) (10 rep. / 3 sets with 5 min rest in between) for 30 minutes, 3 sessions / week in addition to lifestyle modification advice for 4 weeks.

Core stability exerciseOTHER

The participants will perform core stability exercises (spinus multifiduse ex, diaphragmatic strengthening ex, frontal plank, pelvic floor ex,) 3 sessions / week for 30 min each session in addition to lifestyle modification advice for 4 weeks

Lifestyle modification adviceOTHER

The participants will receive lifestyle modification advice only for 4 weeks

Eligibility

Sex: FEMALEMin age: 50 YearsMax age: 60 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Sixty postmenopausal women (at least one year after stoppage of menses). * Their age will be ranged from 50 to 60 years. * All of them are diagnosed with chronic low back pain. * Their BMI will be less than 30 kg/ m2. * All of them are of sedentary lifestyle. * The score of pain will be 2 or more in a VAS. Exclusion Criteria: * Participants will be excluded from the study if they have: * Spinal fractures or any other neurological disorders. * Lumber disc herniation or spondylolithesis * Body mass index more than 30 kg/m2. * Pelvic pathology * Gynecological diseases as chronic pelvic pain, uterine prolapse or retroversion flexion of the uterus.

Locations (1)

Hala Ali Mohamed

Cairo, Egypt

Outcomes

Primary Outcomes

Pain intensity level

The intensity of postmenopausal low back pain will be assessed using a visual analogue scale (VAS) for all participants in the three groups before and after treatment, which is a method of representing subjects' pain on a 10 cm linear scale. A score of 0 means " no pain" and 10 means " very high degree of pain

Time frame: 4 weeks

Lumbar flexion range of motion

The modified Schober test will be used to measure the lumbar flexion range of motion (ROM) by using the tape measurement. Each participant will be asked to stand erect with her feet about shoulder-width apart to stabilize the pelvis. Then, the posterior superior iliac spines(PSIS) will be determined by the therapist's both thumbs, and then an ink line will be drawn along the midline of the lumbar spines horizontal to the PSIS to mark the midpoint between the two PSIS. Then tape will be used to identify and mark two points: one is 10 cm superior to the midpoint (A), and another is 5 cm inferior to the midpoint (B). The participant will be instructed to bend forward as much as she can while keeping both knees straight, the new distance between superior and inferior skin marking will be measured in centimeters. The increased distance along the tape due to lumbar flexion is normally about 6-7 cm (less than 5 cm should be considered abnormal).

Time frame: 4 weeks

Lumbar extension range of motion

The modified Schober test will be used to measure the lumbar extension range of motion (ROM) by using the tape measurement while the patient is in a standing position. The participant will be instructed to put her hands on her buttocks and bend backward into full lumbar extension and the new distance between the superior and inferior skin markings will be measured in centimeters by the tape measurement. The change in the difference between the marks is used to indicate the amount of lumbar extension. The increased distance along the tape due to the extension of the lumbar spine is normally about 2-3 cm (less than 1cm should be considered abnormal).

Time frame: 4 weeks

Assessment of lateral flexion range of motion

The participant will be asked to stand erect with her feet about shoulder-width apart. Both right and left lateral flexion will be measured by the tape as the distance from the tip of the index finger to the floor at maximal comfortable lateral flexion. The participant will be instructed to bend her trunk laterally as much as she can. The normal value of lateral spinal flexion is 16.2-28.0 cm.