Comparison of Stretching and MET in Lower Cross Syndrome

Comparing the Effects of Stretching and Muscle Energy Technique in the Management of Lower Cross Syndrome

The aim of the study is to compare the effects of stretching exercises & muscle energy techniques in the management of lower cross syndrome and to find the effective treatment in the lower cross syndrome management.

Study Overview

• Status: Completed
• Conditions: Cross Syndrome
• Intervention / Treatment: Other: Muscle energy technique; Other: Stretching

Detailed Description

In 2015 the systematic review estimated that prevalence of Chronic low back pain in 24 to 39 year old individual was 4.2% and the individual between 20 to 59 was 19.6% . The genesis and perpetuation of Low back pain (LBP) has many underlying factors among which one is proposed by Janda's concept of pelvic crossed syndrome. This condition describes a pattern of tight and weak muscles around the pelvis. Marked postural deviation is seen such as increased lumber lordosis and depending on this lordosis the muscle involvement can be distinguished. The center of the gravity is slightly anterior to S1 or S2, which means pelvis position, is key to faulty or good alignment.

Various studies have been done on muscle imbalance Lower crossed syndrome (LCS) using Stretching and Muscle energy Technique (MET). Both have shown superior effects when compared to other treatment modalities/techniques. However there is paucity of literature on effectiveness of stretching and MET in management of LCS.

• Study Type: Interventional
• Enrollment (Actual): 58
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • KPK
    • Peshawar, KPK, Pakistan, 25000
      • Bibi Zahida Memorial Teaching Hospital NCS

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 50 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• LCS pattern in standing position
• Patients having Chronic low back pain
• Age : 20-50 years
• Both male and females
• Positive Prone Hip Extension movement pattern test

Exclusion Criteria:

• Fracture (wedge compression #)
• Inflammatory disorder
• Acute disc bulge
• Lumber instability
• Idiopathic scoliosis
• Patient with Rheumatoid arthritis (RA) and other systemic diseases

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Muscle energy technique; Muscle energy technique applied in the lower cross syndrome muscle pattern.	Other: Muscle energy technique; Muscle energy technique for illiopsoas, rectus femoris, erector spinae & hamstrings muscles duration of contraction was 10 sec, rest interval was 5 sec, stretch duration was 30 sec, number of repetition of stretch was 5, number of set was 1, frequency per week was 3
Active Comparator: Stretching; Stretching technique applied in the lower cross syndrome muscle pattern.	Other: Stretching; Stretching exercises for illiopsoas, rectus femoris, erector spinae & hamstrings muscles duration of stretch was 15 sec, rest interval was 5 sec, number of repetition was 5, number of set was 1, frequency per week was 3

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numeric pain rating scale	It was calculated through Numeric pain rating scale (NPRS) in which 0 was the lowest value with no pain label and 10 was the highest value with worst possible pain label. The Subjects with respect to their pain intensity were asked to mark a level of NPRS.	4th week
ROM assessment of iliopsoas	Range of motion (ROM) was taken via goniometer for iliopsoas was measured with double inclinometer.	4th week
ROM assessment of rectus femoris	Range of motion (ROM) was taken via goniometer for rectus femoris was measured with double inclinometer.	4th week
ROM assessment of hamstrings	Range of motion (ROM) was taken via goniometer for hamstrings was measured with double inclinometer.	4th week
ROM assessment of erector spinae	Range of motion (ROM) was taken via goniometer for erector spinae was measured with double inclinometer.	4th week

Collaborators and Investigators

• Sponsor: Riphah International University

Publications and helpful links

General Publications

• Frank C, Page P, Lardner R. Assessment and treatment of muscle imbalance: the Janda approach: Human kinetics; 2009.
• Key J, Clift A, Condie F, Harley C. A model of movement dysfunction provides a classification system guiding diagnosis and therapeutic care in spinal pain and related musculoskeletal syndromes: a paradigm shift-Part 1. J Bodyw Mov Ther. 2008 Jan;12(1):7-21. doi: 10.1016/j.jbmt.2007.04.005. Epub 2007 Jun 11.
• Kolar P. Facilitation of agonist-antagonist co-activation by reflex stimulation methods. Rehabilitation of the Spine. 2007:531-65.
• Norkin CC, White DJ. Measurement of joint motion: a guide to goniometry, 5th edition: FA Davis; 2016.
• Kage MV. Effectiveness of Stretching and Strengthening Exercises in Patients with postural Low Back Pain A Randomized Controlled Trial. 2017.
• Abutaleb EE, Eldesoky MT, El Rasol SA. Effect of Muscle Energy Technique on Anterior Pelvic Tilt in Lumbar Spondylosis Patients. World Academy of Science, Engineering and Technology, International Journal of Medical, Health, Biomedical, Bioengineering and Pharmaceutical Engineering. 2015;9(8):651-5.
• Ahmed ET, Abdelkarim SS. Efficacy of muscle energy technique versus static stretching technique in increasing hamstring flexibility post burn contracture. Int J Health Rehabil Sci. 2013;2(1):22-7.

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2018
• Primary Completion (Actual): December 1, 2018
• Study Completion (Actual): December 20, 2018

Study Registration Dates

• First Submitted: December 9, 2020
• First Submitted That Met QC Criteria: December 9, 2020
• First Posted (Actual): December 16, 2020

Study Record Updates

• Last Update Posted (Actual): December 16, 2020
• Last Update Submitted That Met QC Criteria: December 9, 2020
• Last Verified: December 1, 2020

More Information

Terms related to this study

• Keywords: stretching; Muscle energy technique; Lower cross syndrome
• Additional Relevant MeSH Terms: Pathologic Processes; Disease; Syndrome
• Other Study ID Numbers: REC/00383 Nouman Khan

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