Hamstring Stretching Effective on Nonspecific Low Back Pain (Hams)

Does Hamstring Stretching Effective on Nonspecific Low Back Pain?"

Low back pain is one of the most common complaints in the world and can be considered a universal health problem for humanity. Low back pain is a multifactorial disease with multiple etiologies. Risk factors are difficult to identify. It is reported in the literature that 70-80% of the world's population has low back pain at some point in their lives, and 95% of this pain is mechanical. Mechanical low back pain (MBA) can be described as a clinical picture that develops as a result of overuse, strain, traumatization or deformation of the structures that make up the spine. In order to define low back pain mechanically, all organic causes such as inflammatory, infectious, tumoral, metabolic causes, fractures and pain reflected from internal organs must be excluded. The most common diseases that cause low back pain are; They are caused by mechanical factors and degenerative diseases. Mechanical and static stresses can lead to joint blockage, restricting the range of motion of the joint along with pain. Non-Specific many factors affect low back pain. Kim and Shin reported that asymmetry of hip extension range of motion of both hip joints was associated with nonspecific low back pain rather than simple hip extension range of motion, and they found that limiting hip extension was compensatory.

Study Overview

• Status: Completed
• Conditions: Low Back Pain
• Intervention / Treatment: Other: Exercise

• Study Type: Interventional
• Enrollment (Actual): 46
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul
    • Istanbul, Istanbul, Turkey (Türkiye), 34720
      • Eylül Pınar Kısa

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Patients with complaints of low back pain,
• NLBP for at least 12 weeks,
• finger-to-ground distance greater than 0 cm; a passive straight-leg raising -(SLR) angle of less than 80°, measured with a hand-held goniometer;
• normal mobility of the hip;
• passive knee extension ≥25°,
• VAS score between 3 and 7 will be included.

Exclusion Criteria:

• People with a history of hamstring injury in the last two years,
• fractures in the spine or lower extremities,
• pregnancy,
• leg length difference of more than 2 cm,
• and obesity will be excluded from the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: exercise group; Exercise program and 3 way hamstring strech will be applied.	Other: Exercise; It consist of traditional exercises.
Other: control group; Just Exercise program will be applied.	Other: Exercise; It consist of traditional exercises.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Flexibility assessment	During the Passive Knee Extension Test, participants will be positioned supine with the hip of the tested limb flexed to 90° while the contralateral limb will be stabilized. The examiner gradually extended the knee until resistance or discomfort will reported. The knee extension angle will be measured using a digital goniometer and recorded in degrees.	0-4 week
Flexibility assessment	fingertip-to-floor (FTF) test, participants stood on a 20-cm step and will instructed to bend forward and reach toward the floor without flexing their knees. The distance between the third fingertip and the floor will measured using a tape measure and recorded in centimeters. The minimal detectable change (MDC) for the FTF test is reported as 4.5 cm	0-4 week
Flexibility assessment	Sit- and-reach test (SRT) participants sİt with their knees fully extended and feet position against the testing box. They are instructed to reach forward as far as possible while keeping their knees extended. The furthest distance reached will recorded in centimeters	0-4 week

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Functionality index	Functional Rating Index (FDI) was obtained by combining similar structures of the neck disability index and the Osweestry low back pain disability index, and its validity and reliability have been proven. The validity and reliability of the Turkish version of this survey was conducted by Bayar et al. in 2004. FDI consists of 10 parts that measure the function of the spinal musculoskeletal (waist, neck pain) system and pain. Eight address activities of daily living that may be affected by the spinal condition. Two of them address 2 different characteristics of pain. Using a 5-choice scale for each item, the amount of current pain or perceived ability to function is ranked by selecting 5 response points. 0=no pain or full function, 1=mild pain or mild limitation, 2=moderate pain or moderate limitation, 3=severe pain or severe limitation, 4=worst pain or inability to function. Scoring varies between 0-40, and as the score increases, functional status worsens	0-4 week
Functional disability	Functional disability will be assessed using the Oswestry Disability Index (ODI). The ODI consists of 10 items evaluating pain intensity and disability during daily activities. Each item will be scored from 0 to 5, with higher scores indicating greater disability. The Turkish version of the ODI has demonstrated acceptable validity and reliability (Yakut et al., 2004). ODI scores will be categorized as minimal (0-20), moderate (21-40), severe (41-60), crippled (61-80), and bed-bound (81-100) disability. A 30% improvement from baseline will be considered the threshold for clinically meaningful improvement in individuals with low back pain.	0-4 week
Pain status	Pain status Patients pain status were evaluated with VAS between 0 and 10 for low back pain during movement. (No pain at 0 points, severe pain at 10 points)	0-4 week
Jump performance	Vertical jump performance will be assessed using the squat jump (SJ) test. Participants will start from a semi-squat position without preparatory countermovement and will be instructed to jump as high as possible. Jump height will be measured using a Vertec system, which has demonstrated acceptable validity and reliability for vertical jump assessment. Three trials will be performed under standardized conditions, and the highest value will be recorded. Jump height will be calculated as the difference between standing reach height and maximal jump reach height and will be recorded in centimeters.	0-4 week

Collaborators and Investigators

• Sponsor: Biruni University

Study record dates

Study Major Dates

• Study Start (Actual): December 12, 2023
• Primary Completion (Actual): January 1, 2024
• Study Completion (Actual): August 10, 2024

Study Registration Dates

• First Submitted: December 13, 2023
• First Submitted That Met QC Criteria: February 19, 2025
• First Posted (Actual): February 20, 2025

Study Record Updates

• Last Update Posted (Actual): July 22, 2026
• Last Update Submitted That Met QC Criteria: July 20, 2026
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Back Pain; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Low Back Pain; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Exercise
• Other Study ID Numbers: Hamstring

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
• product manufactured in and exported from the U.S.: No