]>
IRCT20130409012953N3 IRCT 2018-04-29 Baqiyatallah University of Medical Sciences Effect of lumbar mobilization, muscle energy technique, and slump stretching with exercise on low back pain Effect of lumbar mobilization, muscle energy technique, and slump stretching with exercise in patients with non-specific low back pain: A randomized clinical trial. 2018-05-22 anticipated 36 Complete https://irct.ir/trial/30512 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: All eligible chronic non-specific low back pain participants will be randomly assigned to a mobilization (group 1), muscle energy technique (group 2), or a slump stretching (group 3) group with a ratio of 1:1:1. Randomization will be performed using a block-balanced randomization technique with 6 character blocks containing letters A, B, and C. After randomizing, the randomization schedule will be transferred into written instructions and will be placed in sequentially numbered, opaque, and sealed envelopes. The procedure will be performed by an investigator who will not be involved with participants assessment and treatment, Blinding description: In this study, outcomes assessor will not be informed about the intervention that chronic non-specific low back pain patients received during the treatment. N/A Chronic non-specific low back pain is defined as pain persisting for a period of greater than 3 months, localized between the costal margin and the inferior gluteal folds, without referred leg pain and that is not caused by a known specific pathology.. Intervention 1: Intervention group 1: Lumbar spine postero-anterior mobilization and stabilization exercises- In this group, each participant will receive approximately 10 minutes of lumbar spine mobilization to the hypomobile segments identified during the initial examination. Each participant will be positioned in prone on a treatment table with a small pillow will be placed under the abdomen to enhance his/her comfort. A graded posterior–anterior mobilization (grade II and III) will be provided to the most provocative vertebral segment for three sets of 40-second oscillations. All other hypomobile lumbar segments will be mobilized for two sets of 40-second oscillations. Following mobilization, the participants will perform lumber stabilization exercise. Each participant will perform two sets of 10 repetitions of wall squat, bridge, pelvic tilt, and quadruped arm and leg lifts. Intervention 2: Intervention group 2: Muscle energy technique and stabilization exercises- The participant will sit upright on a treatment table with the hands resting on the opposite shoulders. The physical therapist will stand close to the participant and will ask him/her to perform lumbar flexion movement to the maximum available range. Then, the participant will be instructed to perform a submaximal isometric contraction (20-25% maximum voluntary isometric contraction) of the paraspinal muscles against the physical therapist resistive force and maintain this contraction for 5 seconds. Afterward, the participant will be asked to relax the contraction and the physical therapist will move the trunk into the new range. This technique will be repeated three time in each treatment session. Following muscle energy technique, the participants will perform lumber stabilization exercise. Each participant will perform two sets of 10 repetitions of wall squat, bridge, pelvic tilt, and quadruped arm and leg lifts. Intervention 3: Intervention group 3: Slump stretching and stabilization exercises- Slump stretching exercises will be provided by the physical therapist. The participant will be positioned in long sitting, feet against a wall to maintain neutral dorsiflexion angle, trunk will be flexed to enhance dural elongation, while the physical therapist will apply cervical overpressure to ensure a consistent pressure just at the onset of symptom provocation. Five repetitions of 30-second holds will be performed. Following slump stretching, the participants will perform lumber stabilization exercise. Each participant will perform two sets of 10 repetitions of wall squat, bridge, pelvic tilt, and quadruped arm and leg lifts. Yes - There is a plan to make this available What will be shared: Deidentified individual participant data collected for the primary and secondary outcome measures will be shared if necessary. When: Starting 6 months after publication To whom: The data will be available for physical therapists working in academic institutions and also clinicians working in the field of musculoskeletal disorders Conditions: The raw data and results of this study can be used in future relevant systematic reviews. Thus, the raw data and results of this study will be available for researchers working in the field of low back pain. Where to obtain: Applicants can contact Dr. Mohammad Reza Pourahmadi (PT, PhD) by email. Email address: pourahmadipt@gmail.com How to obtain: Applicants should explain in detail about their project and how the data/documents of this study will be used in their project. Then, the data/documents files will be sent by email to applicants on request. This process may takes 10-12 working days. Comments:
public Mohammad Reza Pourahmadi
School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Madadkaran All., Shahnazari St., Madar Sq., Mirdamad Blvd., Tehran
Tehran Iran (Islamic Republic of) 4391-15875 +98 21 2222 2059 pourahmadipt@gmail.com Iran University of Medical Sciences scientific Mohammad Reza Pourahmadi
School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Madadkaran All., Shahnazari St., Madar Sq., Mirdamad Blvd., Tehran
Tehran Iran (Islamic Republic of) 4391-15875 +98 21 2222 2059 pourahmadipt@gmail.com Iran University of Medical Sciences Iran (Islamic Republic of) Low back pain persisting for more than 3 months in the absence of an underlying pathology Aged between 18 and 40 years No contraindication for exercise No history of surgery in the lumbar region No obvious scoliosis No sensory and motor deficits in the lower extremities No vertebral fracture No severe discopathy 18 years 40 years Both Smoking Any recent trauma to the musculoskeletal system such as bony, muscular, ligamentous, and soft tissue structures in the lower extremities and trunk that might interfere with the treatment Body mass index above 30 kg/m2 Absence for 3 consecutive treatment sessions M54.5 Low back pain Rehabilitation Rehabilitation Rehabilitation Intervention group 1: Lumbar spine postero-anterior mobilization and stabilization exercises- In this group, each participant will receive approximately 10 minutes of lumbar spine mobilization to the hypomobile segments identified during the initial examination. Each participant will be positioned in prone on a treatment table with a small pillow will be placed under the abdomen to enhance his/her comfort. A graded posterior–anterior mobilization (grade II and III) will be provided to the most provocative vertebral segment for three sets of 40-second oscillations. All other hypomobile lumbar segments will be mobilized for two sets of 40-second oscillations. Following mobilization, the participants will perform lumber stabilization exercise. Each participant will perform two sets of 10 repetitions of wall squat, bridge, pelvic tilt, and quadruped arm and leg lifts. Intervention group 2: Muscle energy technique and stabilization exercises- The participant will sit upright on a treatment table with the hands resting on the opposite shoulders. The physical therapist will stand close to the participant and will ask him/her to perform lumbar flexion movement to the maximum available range. Then, the participant will be instructed to perform a submaximal isometric contraction (20-25% maximum voluntary isometric contraction) of the paraspinal muscles against the physical therapist resistive force and maintain this contraction for 5 seconds. Afterward, the participant will be asked to relax the contraction and the physical therapist will move the trunk into the new range. This technique will be repeated three time in each treatment session. Following muscle energy technique, the participants will perform lumber stabilization exercise. Each participant will perform two sets of 10 repetitions of wall squat, bridge, pelvic tilt, and quadruped arm and leg lifts. Intervention group 3: Slump stretching and stabilization exercises- Slump stretching exercises will be provided by the physical therapist. The participant will be positioned in long sitting, feet against a wall to maintain neutral dorsiflexion angle, trunk will be flexed to enhance dural elongation, while the physical therapist will apply cervical overpressure to ensure a consistent pressure just at the onset of symptom provocation. Five repetitions of 30-second holds will be performed. Following slump stretching, the participants will perform lumber stabilization exercise. Each participant will perform two sets of 10 repetitions of wall squat, bridge, pelvic tilt, and quadruped arm and leg lifts. Pain. Timepoint: Before intervention and 3, 6 sessions after intervention. Method of measurement: Numeric Pain Rating Scale. Lumbar spine flexion and extension range of motion. Timepoint: Before intervention and 3, 6 sessions after intervention. Method of measurement: Smartphone application (iHandy level). Functional disability. Timepoint: Before intervention and 3, 6 sessions after intervention. Method of measurement: Persian version of Roland-Morris Disability Questionnaire and Oswestry Disability Questionnaire. Fear avoidance beliefs. Timepoint: Before intervention and 3, 6 sessions after intervention. Method of measurement: Persian version of fear-avoidance beliefs questionnaire. Baqiyatallah University of Medical Sciences Approved 2017-11-14 The Ethics committee at the Baqiyatallah University of Medical Sciences Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, South Sheykh Bahayi Street, Molasadra blvd, Vanak Sq, Tehran, Iran Tehran Tehran Iran (Islamic Republic of)