William Training Versus Hold Relax Stretching of Iliopsoas Muscle

Effects of William Training Versus Hold Relax Stretching of Iliopsoas Muscle in Females With Hyperlordosis

Hyper lordosis is a condition in which there is an excessive spine curvature in the lower back. Hyper lordosis is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain.Hyper lordosis creates a characteristic C-shaped curve in the lower back, or lumbar region, where the spine curves inward just above the buttocks. It often occurs as a result of poor posture or a lack of exercise. Hyperlordosis can cause muscle tightening and stiffness in the lower back. It can also damage the spine and soft tissues in the lumbar region. Hyperlordosis leads to excessive curvature of the spine in the lower back, causing the abdomen and buttocks to appear more prominent in profile view. People with hyperlordosis may experience mild to severe lower back pain, which may worsen with movement.

Various conservative treatments are used to treat hyperlordosis and low back pain due to hyperlordosis. Most commonly used are the manual therapy techniques that employ William's protocol and hold relax stretching of iliopsoas muscle at lumbar spine. This study will be randomized control trial used to compare the effects of William protocol and hold relax stretching of iliopsoas muscle in subjects with hyperlordosis and low back pain. Subjects meeting the predetermined inclusion and exclusion criteria will be divided into two groups using lottery method. Pre assessment will be done using LUMBAR SPINE QUESTIONNAIRE as subjective measurements and NPRS as objective measurements. Subjects in one group will be treated using William's protocol and the other one will be treated with hold relax stretching of iliopsoas muscle. Each subject will receive 08 treatment sessions with 02 treatment sessions per week. Post treatment reading for NPRS and lumbar spine questionnaire will be recorded after every week.

Study Overview

• Status: Recruiting
• Conditions: Hyperlordosis
• Intervention / Treatment: Other: HOLD RELAX STRETCHING OF ILIOPSOAS; Other: WILLIAM'S PROTOCOL

Detailed Description

Hyper lordosis is a condition in which there is an excessive spine curvature in the lower back. Hyper lordosis is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain.Hyper lordosis creates a characteristic C-shaped curve in the lower back, or lumbar region, where the spine curves inward just above the buttocks. It often occurs as a result of poor posture or a lack of exercise. Hyperlordosis can cause muscle tightening and stiffness in the lower back. It can also damage the spine and soft tissues in the lumbar region. Hyperlordosis leads to excessive curvature of the spine in the lower back, causing the abdomen and buttocks to appear more prominent in profile view. People with hyperlordosis may experience mild to severe lower back pain, which may worsen with movement.

Various conservative treatments are used to treat hyperlordosis and low back pain due to hyperlordosis. Most commonly used are the manual therapy techniques that employ William's protocol and hold relax stretching of iliopsoas muscle at lumbar spine. This study will be randomized control trial used to compare the effects of William protocol and hold relax stretching of iliopsoas muscle in subjects with hyperlordosis and low back pain. Subjects meeting the predetermined inclusion and exclusion criteria will be divided into two groups using lottery method. Pre assessment will be done using LUMBAR SPINE QUESTIONNAIRE as subjective measurements and NPRS as objective measurements. Subjects in one group will be treated using William's protocol and the other one will be treated with hold relax stretching of iliopsoas muscle. Each subject will receive 08 treatment sessions with 02 treatment sessions per week. Post treatment reading for NPRS and lumbar spine questionnaire will be recorded after every week.Various conservative treatments are used to treat hyperlordosis and low back pain due to hyperlordosis. Most commonly used are the manual therapy techniques that employ William's protocol and hold relax stretching of iliopsoas muscle at lumbar spine. This study will be randomized control trial used to compare the effects of William protocol and hold relax stretching of iliopsoas muscle in subjects with hyperlordosis and low back pain. Subjects meeting the predetermined inclusion and exclusion criteria will be divided into two groups using lottery method. Pre assessment will be done using LUMBAR SPINE QUESTIONNAIRE as subjective measurements and NPRS as objective measurements. Subjects in one group will be treated using William's protocol and the other one will be treated with hold relax stretching of iliopsoas muscle. Each subject will receive 08 treatment sessions with 02 treatment sessions per week. Post treatment reading for NPRS and lumbar spine questionnaire will be recorded after every week.

• Study Type: Interventional
• Enrollment (Anticipated): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab
    • Lahore, Punjab, Pakistan, 54660
      • Recruiting
      • Jinnah Hospital
      • Contact: Hafiza MEhjabeen, PP-Dpt; Phone Number: 03026577666; Email: hafiza.mehjabeen@riphah.edu.pk
      • Principal Investigator: Faiza Mubeen, MS-WHPT
      • Sub-Investigator: Hafiza Mehjabeen, PP-Dpt

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years to 40 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Age 21-40 years
• Hyperlordosis Angle
• Females having increased lordotic curve
• Pain perceived anywhere in the region of lumbar spine from L1 to l5.
• Limitation of lumbar spine range of motion.

Exclusion Criteria:

• Any red flags including tumors, fractures.
• Spinal canal stenosis
• Rheumatoid arthritis
• Osteoporosis

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: HOLD RELAX STRETCHING OF ILIOPSOAS; 10-second isometric contraction of iliopsoas muscle (HR), 10-second rest, 20-second static stretch, 5 repetitions. The stretching exercise was performed 2 times a week for 8 weeks.	Other: HOLD RELAX STRETCHING OF ILIOPSOAS; 10 second isometric contraction of iliopsoas muscle (HR), 10-second rest, 20 second static stretch, 5 repetitions. • The stretching exercise was performed 2 times a week for 8 weeks. 10 second isometric contraction of iliopsoas muscle (HR), 10-second rest, 20 second static stretch, 5 repetitions. The stretching exercise was performed 2 times a week for 8 weeks.
Experimental: • WILLIAM'S PROTOCOL; Pelvic tilt; Single Knee to chest; Double knee to chest; Partial sit-up; Hamstring stretch; Hip Flexor stretch; Squat; Each group performed special trainings for 8 weeks, 2 sessions per week; each session took about 1 hour. Duration of each exercise was 8 to 10 seconds in each set. Protocols were started with 1 set of 10 repetitions at starting baseline and by improving performance and patients' compatibility with trainings, all eventually finished with 3 sets of 20 repetitions at the end of protocols.	Other: WILLIAM'S PROTOCOL; Pelvic tilt Single Knee to chest Double knee to chest Partial sit-up Hamstring stretch Hip Flexor stretch Squat Each group performed special trainings for 8 weeks, 2 sessions per week; each session took about 1 hour. Duration of each exercise was 8 to 10 seconds in each set. Protocols were started with 1 set of 10 repetitions at starting baseline and by improving performance and patients' compatibility with trainings, all eventually finished with 3 sets of 20 repetitions at the end of protocols.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pain assessment	The NRS for pain is a unidimensional measure of pain intensity in adults including those with chronic pain due to rheumatic diseases. Although various iterations exist, the most commonly used is the 11-item NRS	8 weeks
lordatic angle	2- Flexicurve ruler: The angle of lumbar lordosis will be measured with a flexible ruler. The subject remained in the normal standing posture while lordatic angle was measured	8 weeks
low back pain	3- Lumbar spine questionnaire (LSQ): It is used for the assessment of low back pain. It contains various items and patients will be asked relevant questions and answers will be noted and written	8 weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Hafiza Mehjabeen, MSWHPT, Riphah International University

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2022
• Primary Completion (Anticipated): September 1, 2022
• Study Completion (Anticipated): September 1, 2022

Study Registration Dates

• First Submitted: July 14, 2022
• First Submitted That Met QC Criteria: July 14, 2022
• First Posted (Actual): July 15, 2022

Study Record Updates

• Last Update Posted (Actual): September 7, 2022
• Last Update Submitted That Met QC Criteria: September 5, 2022
• Last Verified: September 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nutrition Disorders; Musculoskeletal Diseases; Deficiency Diseases; Malnutrition; Spinal Diseases; Bone Diseases; Spinal Curvatures; Lordosis; Swayback
• Other Study ID Numbers: REC/RCR&AHS/22/0520

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