Effects of Mezieres Method on Muscle Imbalance, Body Awareness and Postural Alignment in Athletes With Lower Back Pain. (MEZ-LBP)

May 20, 2026 updated by: Wayna Maqsood, Green International University
The current study is a randomized controlled trial aims to compare the effectiveness of the Mezieres Method combined with core stabilization versus routine physiotherapy involving core stabilization on muscle imbalance, body awareness, and postural alignment in athletes with lower back pain. Eligible participants will be randomly allocated into two groups: an experimental group receiving the Mezieres Method plus core stabilization exercises and a control group receiving routine physiotherapy treatment involving core stabilization alone. Outcomes related to muscle imbalance, body awareness, postural alignment, and pain/function will be assessed before and after the intervention period. The study seeks to determine whether the Mezieres Method combined with core stabilization provides additional benefits in athletes with lower back pain.

Study Overview

Status

Status

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

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

Low back pain (LBP) is the type of musculoskeletal problems affecting athletes in many sports, and it is approximately about 80% of them experience at least one episode during their career and many of them later develops long duration or recurrent pain that definitely impact performance, training routine and also day-today quality of life . Lower back pain is one of the most common musculoskeletal conditions worldwide, particularly among athletes because of repetitive strain, poor biomechanics, and muscle imbalances. In the world wide, studies estimate that nearly 60-80% of individuals experience low back pain at some point in their lives, with a point prevalence of about 7-12% in the total population and even higher rates reported in athletic populations due to intensive physical demands. In sports communities, the prevalence can range from 20% to 50%, depending on the type of sport, training intensity, and postural habits. Locally, in countries like Pakistan, the burden of low back pain is also significantly high, although underreported; hospital-based and regional studies suggest prevalence rates ranging from 30% to 70% among adults, with athletes and physically active individuals being at increased risk due to inadequate conditioning, poor posture, and lack of body awareness. These rising trends focused the importance of effective rehabilitation approaches such as the Mezieres method, which mostly focuses on correcting muscle imbalance, improving body awareness, and restore the good postural alignment. In early morning many athletes often complain more stiffness and they are type of more predisposed to LBP because of routine mechanical loading, postural strains, asymmetric movements and high demands on spinal flexibility and strength. Sports like gymnastics, soccer and dance place unusual stress on the lumbar region through repeated hyperextension, twisting and high-impact movements, which sort of increase the risk even more. These biomechanical stresses can lead to muscle imbalance, postural changes and sometimes impaired neuromuscular control, and all of this basically keep the pain going with functional limitation. The pathophysiology of LBP in athletes sometimes includes multifactorial origins including poor lumbopelvic stability, weak core muscles and asymmetrical tension in posterior muscular chains. This muscular imbalance can disrupt spinal alignment and even change the proprioceptive control so athletes start using compensatory movement patterns and recurrent injury kind of occurred again. Traditional physical therapy usually emphasis on strengthening the core, better flexibility and decrease pain with therapeutic exercises and manual therapy. Core stabilization exercises in especially have shown good efficacy on patients in improving spinal stability, posture and reducing LBP intensity. So the present study is purpose to compare effects of Mezieres Method combined with core stabilization exercises to routine physiotherapy (core stabilization exercises alone) on muscle imbalance, body awareness and postural alignment in athletes with lower back pain. And by doing so it seeks to determine whether integration of global postural re-education offers additional benefits over conventional therapeutic practices and whether difference between groups is clinically meaningful for athletes who receive these treatments.

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 (Actual)

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 Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Green International University

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

No

Description

Inclusion Criteria:

  • Diagnosed with non-specific LBP lasting at least three months with following test (Straight Leg Raise Test, Slump Test, Schober's Test )
  • Athletes aged 18-35 years of either gender
  • Athletes should exhibit signs of postural imbalance or muscular chain dysfunction
  • Functional limitation related to posture or movement.
  • Patient undergoing physiotherapy intervention for musculoskeletal disorders.
  • Reduced trunk mobility, impaired postural alignment, or functional defects.

Exclusion Criteria:

  • History of spinal surgery, fracture, or structural deformity (e.g., scoliosis, spondylolisthesis).
  • Neurological or systemic disorders affecting balance or muscle control
  • Current use of medications that may effect musculoskeletal performance (e.g., corticosteroids, muscle relaxants)
  • Pregnancy or any contraindication to physical activity

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

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: Mezieres method plus core stabilization
Participants in this arm will receive the Mezieres Method combined with core stabilization exercises. The intervention will focus on global postural stretching, correction of muscle chain imbalance, breathing control, body awareness training, and activation of deep core muscles to improve postural alignment and functional outcomes in athletes with lower back pain. Treatment sessions will be supervised by a physiotherapist and conducted according to the study protocol throughout the intervention period.
Other: Mezieres method plus core stabilization
Participants in Group A was receive Mezières method therapy, focusing on progressive stretching and postural correction aimed at restoring muscle balance and improving awareness of body alignment. Sessions was target major posterior chain muscles, including the erector spinae, hamstrings, and gluteal muscles, using slow, sustained stretching techniques. Each Mezières session was last 30-35 minutes, followed by core stabilization exercises for 15-20 minutes, including plank variations, bridging exercises, and abdominal hollowing techniques to enhance trunk stability. Interventions was administered 3 times per week for 6 weeks by a trained physiotherapist.
Other Names:
  • Group A intervention
Active Comparator: Routine physiotherapy (core stabilization)
Participants in this arm will receive routine physiotherapy management consisting of conventional core stabilization exercises, lumbar strengthening, stretching exercises, and standard physiotherapy rehabilitation techniques commonly used for lower back pain in athletes. Sessions will be conducted with the same treatment frequency and duration as the experimental group.
Other: Routine physiotherapy (core stabilization)
Participants in Group B was perform the same core stabilization exercises as Group A, without Mezières intervention. Exercises was target deep abdominal muscles, multifidus, and pelvic stabilizers, purpose is to improve trunk stability and support postural alignment. Each session was last 20-25 minutes, conducted 3 times per week for 6 weeks, under supervision to ensure correct technique and progression.
Other Names:
  • Group B intervention

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
Muscle Imbalance
Time Frame: Baseline and after six weeks
Muscle imbalance refers to unequal strength or flexibility between opposing lumbar pelvic muscle groups. Muscle imbalance will be assessed using the NYPRC postural alignment and muscle imbalance assessment protocol. The NYPRC evaluates postural deviations and muscle imbalance patterns through observational assessment of body alignment in standing posture. Scores are assigned to different body segments, with lower scores indicating greater postural deviation and muscle imbalance and higher scores indicating better alignment.
Baseline and after six weeks
Postural Alignment
Time Frame: Baseline and after six weeks
Postural alignment refers to the biomechanical positioning of the spine and pelvis across sagittal, frontal, and transverse planes. The New York Posture Rating Chart (NYPRC) is used to evaluate postural alignment and stability by assessing different body segments. Interpretation: Scores are assigned based on alignment of body parts (head, shoulders, spine, pelvis, etc.) Higher total score = better posture and stability Lower score = poor posture or imbalance
Baseline and after six weeks

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
Body Awareness
Time Frame: Baseline and after six weeks
Body awareness describes one's conscious perception and control of body position and movement. It was measured using the validated Body Awareness Questionnaire (BAQ). Higher scores reflect better proprioceptive integration. Improvements was supported by participants' subjective reports of enhanced comfort, control, and movement confidence during functional tasks.
Baseline and after six weeks
Pain Intensity
Time Frame: Baseline and after six weeks
Pain intensity represents the participant's subjective level of lower back discomfort. It was evaluated using the VAS, ranging from 0 to 10. A clinically meaningful change is defined as a reduction of two or more points, as supported by previous athletic rehabilitation trials.
Baseline and after six weeks

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.
Green International University

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.
January 1, 2025

Primary Completion (Actual)

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 5, 2026

Study Completion (Actual)

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.
May 10, 2026

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).
May 14, 2026

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.
May 20, 2026

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.
May 28, 2026

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.
May 28, 2026

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.
May 20, 2026

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.
May 1, 2026

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.
  • GIU/REC/26-26

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be publicly shared to maintain participant confidentiality and privacy. The study data are intended for academic and research purposes only and are subject to institutional ethical guidelines and consent limitations.

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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