This randomized controlled trial aims to evaluate the combined effects of post-isometric relaxation and myofascial release on pain, flexibility, and functional disability in individuals with low back pain associated with lower cross syndrome. Eligible participants aged 18 to 45 years will be randomly allocated into two parallel intervention groups. One group will receive post-isometric relaxation combined with myofascial release, while the comparison group will receive conventional stretching combined with Therapeutic modalities. Outcomes will be assessed at baseline and after completion of the intervention period. The results of this study are expected to contribute to evidence-based physiotherapy management of low back pain associated with postural imbalance.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
60
Post-isometric relaxation will be applied to the hamstring muscles. Participants will be positioned supine with the hip flexed to 90 degrees and will perform a submaximal isometric contraction of the hamstrings against therapist resistance for 5 to 8 seconds, followed by a passive stretch of approximately 10 seconds. The procedure will be repeated three times per limb per session.
Myofascial release will be applied to the hamstring muscles with the participant in a prone position. Sustained manual pressure will be applied along the length of the hamstring muscles using the therapist's hands for approximately 30 seconds per application, repeated multiple times per session to improve tissue extensibility.
Conventional static stretching of the hamstring muscles will be performed with the participant in a supine position. Each stretch will be held for approximately 30 seconds and repeated three times per limb per session as part of routine physiotherapy management.
Therapeutic modalities, including ultrasound therapy or superficial heat application using a heating pad, will be applied prior to stretching to reduce pain and improve tissue extensibility as part of conventional physiotherapy care.
Department of Physiotherapy, University of Karachi
Karachi, Sindh, Pakistan
Hamstring Flexibility
Hamstring flexibility will be assessed using Active Knee Extension (AKE) test measured in degrees with a goniometer.
Time frame: Outcome measures will be assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)
pain intensity
pain intensity measured by Visual Analogue Scale (VAS)
Time frame: assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)
functional flexibility
assessed by Straight Leg Raise (SLR)
Time frame: Outcome measures will be assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)
posture assesment
Posture will be assessed using the REEDCO scale
Time frame: Outcome measures will be assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)
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