Effects of Lumber Sustained Natural Apophyseal Glides on Lower Cross Syndrome

February 20, 2025 updated by: Riphah International University
A sustained natural apophyseal glide (SNAG) is a mobilization technique commonly used in the treatment of painful movement restrictions of the spine.Studing the effect of Lumber SNAGs in lower cross syndrome hold significance due to its potential to correct pain, hypomobility and biomechanical changes i.e hyperlordotic curve and anterior pelvic tilting caused by lower cross syndrome. The specific muscle imbalance seen in PCS gives rise to specific joint dysfunction, particularly in the L4-L5 and L5-S1 segment of the vertebral column. Over time, this causes stress at the L5-S1 segment of the vertebral column leading to pain and irritation in the lower back Lumber SNAGs encourage improvement of these repositioning error, posture, alleviate discomfort and enhance overall functioning. This research aims to offer patients a noninvasive and personalized approach to managing LCS, ultimately contributing to their overall well-being and movement quality

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

A sustained natural apophyseal glide (SNAG) is a mobilization technique commonly used in the treatment of painful movement restrictions of the spine.Studing the effect of Lumber SNAGs in lower cross syndrome hold significance due to its potential to correct pain, hypomobility and biomechanical changes i.e hyperlordotic curve and anterior pelvic tilting caused by lower cross syndrome. The specific muscle imbalance seen in PCS gives rise to specific joint dysfunction, particularly in the L4-L5 and L5-S1 segment of the vertebral column. Over time, this causes stress at the L5-S1 segment of the vertebral column leading to pain and irritation in the lower back Lumber SNAGs encourage improvement of these repositioning error, posture, eleviate discomfort and enhance overall functioning. This research aims to offer patients a noninvasive and personalized approach to managing LCS, ultimately contributing to their overall well-being and movement quality The significance of this study lies in it's potential to improve the health and wellbeing of adults have pain and hypomobility due to lower cross syndrome.By identifying an effective physical therapy intervention for correcting pain and hypomobility , this study provide valueable insight for clinicians in develping effective treatment strategies.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
36

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Pakistan
    • Azad Kashmir
      • Kotli, Azad Kashmir, Pakistan, 0001
        • Recruiting
        • Orthopaedic hospital
        • Contact:
        • Contact:
        • Principal Investigator:
          • Amreen Shabbir
        • Sub-Investigator:
          • Asmar Fatima

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Age 30 to 50 years.
  • Both genders
  • Patient came with the complain of low back pain.
  • Participants had to present with pain and hypomobility due to lower cross syndrome
  • Participants had to meet the criteria for lower cross syndrome indicating tight hip flexors and erector spinae along with weak abdominals and glutei muscles
  • Participants with hyperlordotic curve due to lower cross syndrome
  • Participants presenting with anterior pelvic tilting greater than angle >7-10 degrees
  • Willing to provide informed consent to participate in study

Exclusion Criteria:Participants contraindicated to spinal manipulation

  • Musculoskeletal pathologies affecting the lower back, pelvis, hips, or lower extremities (e.g., herniated disc, lumbar radiculopathy, lumbar stenosis, hip labral tear).
  • Participants who had undergone any lumber or pelvic surgery, as it will affect sacroiliac joint mechanics.
  • Generalized inflammatory or infective connective tissue disorder
  • Pregnancy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: lumber SNAGS
A sustained natural apophyseal glide (SNAG) is a mobilization technique commonly used in the treatment of painful movement restrictions of the spine.Studing the effect of Lumber SNAGs in lower cross syndrome hold significance due to its potential to correct pain, hypomobility and biomechanical changes i.e hyperlordotic curve and anterior pelvic tilting caused by lower cross syndrome
Other: lumber SNAGS

: Lumber mobilizations with conventional treatment protocol.

  • Lumber Mulligan(SNAGs) technique
  • Technique applied at L4-L5, L5-S1 level.
  • Techniques applied for flexion ,extension, side bending and rotation 6 to 8 cycles per session
Other: Conventional group
Exercises ,Tens and hotpack
Other: Traditional Physical therapy
Conventional treatment protocol including moist Heating pad for low back pain for 15 minutes. TENS for pain for 10 minutes. Stretchings of tight muscles would be 1 set of 5-7 reps with 5 sec. hold 3 times a week. Strengthing of weak muscles would be 2-3 times a weak with 10-15 reps.Stretching protocol will be followed for Iliopsoas and erector spinae muscles. Strengthening protocol will be followed for weak abdominals and Gluteus maximus muscles

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Oswestry disability index
Time Frame: from baseline to 4th week
The Oswestry Low Back Pain Disability Questionnaire is an adequate apparatus used to measure disability caused by low back pain in the general population. The questionnaire examines the level of disability in 10 everyday activities of daily living. Each item consist of 6 statements which are scored from 0 to 5. With 0 indicating the least disability and 5 the greatest then the total score is calculated as a percentage, with 0% indicating no disability and 100% indicating the highest level of disability.
from baseline to 4th week

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Numeric pain rating sacle
Time Frame: from baseline to 4th week
The Numerical Rating Scale (Appendix G) is one of the most commonly used tools to measure pain intensity in both clinical and research settings. The Numerical Rating Scale is an 11-point scale that consists of numbers from 0 to 10, 0 signifies "no pain" and 10 signifies "worst imaginable pain"
from baseline to 4th week
Lumber Range of motion
Time Frame: AT baseline and 3rd week
to test hypomobility in Lumber Spine with the help of Inclinometer
AT baseline and 3rd week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Riphah International University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Asmar Fatima, MS OMPT, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
May 1, 2024

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
March 31, 2025

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 31, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 25, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 26, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 27, 2024

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 25, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 20, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
February 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • REC/MS-PT/01879 Amreen Shabbir

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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