Effect of Extracorporeal Shock Wave on Electrophysiological Changes and Pain in Patients With Lower Cross Syndrome

Lower Cross Syndrome happens when there is muscular imbalance between weak and tight muscles. The tight muscles are generally the hip flexors and erector spinae, and weak muscles are the abdominals and gluteal muscles. Shortening occurs in the hip flexors while weakening occurs in the abdominals and gluteal muscles.

Study Overview

• Status: Completed
• Conditions: Lower Cross Syndrome
• Intervention / Treatment: Other: Conventional physical therapy program; Device: Sham (No Treatment); Other: Extracorporeal shock wave

Detailed Description

Group I (Study): will consist of 20 patients with lower cross syndrome and will receive extracorporeal shock wave in addition to conventional physical therapy program. For 12 sessions every other day, each session for 1 hour.

Group II (Control): will consist of 20 patients with lower cross syndrome and will receive sham extracorporeal shock wave in addition to conventional physical therapy program only same as group (I). For 12 sessions every other day, each session for 1 hour.

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Menoufia
    • Sadat, Menoufia, Egypt
      • Al Ryada University for Science and Technology

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Forty-four lower cross syndrome patients from both genders their ages ranged from 30-45 years old.
2. All patients in present study will be ambulant independently.
3. All patients will be medically stable.
4. The body mass index (BMI) will be ranged from 20:25 Kg/m2.

Exclusion Criteria:

1. Patients with musculoskeletal deformities and disorders.
2. Patients with psychiatric disorders or seizures.
3. Patients with visual and auditory impairment or tremors influencing balance.
4. Patients with other neuromuscular disorders.
5. Patients with BMI more than 25 kg/m2.
6. Patients with cognitive impairment.
7. Patients with lower limb or head and brain surgeries.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Study group (I); Will consist of 20 patients with lower cross syndrome and will receive extracorporeal shock wave in addition to conventional physical therapy program. For 12 sessions every other day, each session for 1 hour.	Other: Conventional physical therapy program; Stretching and strengthening of Iliopoas muscle and Stretching and strengthening of Lower back muscles; Other: Extracorporeal shock wave; Participants will receive (2.5 bars, 2000 pulses, 5 Hz, 7 min) rESWT with 1500 shock targeting the taut band of erector spinae, and 500 around the taut band, by using an EME S.r.l. via Degli Abeti 88/161122 Pesaro [serial number: EM12681015], Italy, shock wave generator.
Experimental: Control group (II); Will consist of 20 patients with lower cross syndrome and will receive sham extracorporeal shock wave in addition to conventional physical therapy program only same as group (I). For 12 sessions every other day, each session for 1 hour.	Other: Conventional physical therapy program; Stretching and strengthening of Iliopoas muscle and Stretching and strengthening of Lower back muscles; Device: Sham (No Treatment); Sham extracorporeal shock wave will be introduced without real shock wave impulses.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analog Scale	Assess pain intensity	4 weeks
Electromyograph	Assess activity of lower back muscles (Erector Spinae)	4 weeks

Collaborators and Investigators

• Sponsor: Ahmed Alshimy

Study record dates

Study Major Dates

• Study Start (Actual): February 2, 2025
• Primary Completion (Actual): November 28, 2025
• Study Completion (Actual): November 29, 2025

Study Registration Dates

• First Submitted: July 29, 2024
• First Submitted That Met QC Criteria: July 29, 2024
• First Posted (Actual): August 1, 2024

Study Record Updates

• Last Update Posted (Actual): May 19, 2026
• Last Update Submitted That Met QC Criteria: May 17, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Pain; Extracorporeal Shock Wave; Electrophysiological changes; Lower Cross Syndrome
• Additional Relevant MeSH Terms: Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain; Therapeutics; Physical Therapy Modalities; Rehabilitation; Ultrasonic Therapy; Diathermy; Hyperthermia, Induced; Extracorporeal Shockwave Therapy
• Other Study ID Numbers: P.T.REC/012/005231

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