Transverse Friction Massage Versus Instrumented Assisted Soft Tissue Mobilization in Quadratus Lumborum Syndrome

Comparative Effects of Transverse Friction Massage Versus Instrument-assisted Soft Tissue Mobilization on Pain, Range of Motion, and Posture in Patients With Quadratus Lumborum Syndrome

To find effective therapeutic interventions for QLS, a study is being conducted to compare the efficacy of two promising techniques: Transverse Friction Massage (TFM) and Instrument-Assisted Soft Tissue Mobilization (IASTM) . Participants will be randomly assigned to either the TFM or IASTM groups. Outcome measures will be collected before and after the intervention, including pain levels assessed through NPRS, range of motion using inclinometer and posture by measuring leg length discrepancy with tape method.Non probability convenience sampling will be used and 34 partcipants will be randomly allocated in two groups after meeting inclusion criteria.Both groups will receive hotpack for 10-15min.Stretching quadratus lumborum will also be performed with strengthening on the opposite side of affected quadratus lumborum.This methodology provides a solid assessment of the effectiveness of TFM and IASTM for Quadratus Lumborum Syndrome therapy.

Study Overview

• Status: Completed
• Conditions: Quadratus Lumborum Syndrome
• Intervention / Treatment: Other: Instrument assissted soft tissue mobilization(IASTM); Other: Transverse friction massage

• Study Type: Interventional
• Enrollment (Actual): 34
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab
    • Lahore, Punjab, Pakistan, 53200
      • Hafiz Medical and diagnostic Center johar town Lahore

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Age group between 18-40years
• Males only with target population was office workers
• NPRS>4
• Patients with a positional fault of the pelvis (lateral tilt)
• Patients having chronic LBP for more than six months
• Hyperirritable spot or taut band
• Positive jump sign for trigger points/ Referred pain related to the trigger point area
• Positive Lewis's functional palpation test for QL overactivity
• At least one trigger point in Quadratus lumborum
• Leg length discrepancy due to QL tightness

Exclusion Criteria:

• Congenital or acquired spinal deformities
• Spinal stenosis or radiculopathy
• Diagnosed disc prolapse
• Rheumatoid arthritis
• Any malignancy
• Recent history of surgery less than three months
• Acute infections

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: Instrument assisted soft tissue mobilization; IASTM (Instrument-Assisted Soft Tissue Mobilization) in four specific body areas for four weeks. The quadratus lumborum, posterior fascia, sacrum, hip lateral rotators, and hamstring bilaterally	Other: Instrument assissted soft tissue mobilization(IASTM); IASTM (Instrument-Assisted Soft Tissue Mobilization) in four specific body areas. The quadratus lumborum, posterior fascia, sacrum, hip lateral rotators, and hamstring bilaterally were these areas. The subjects were asked to kneel directly on the bed to stimulate the lumbar posterior muscles erector spinae (iliocostalis, longissimus), lumborum, and multifidus. At the same time, the IASTM treatment was applied to the rear fascia. The same treatment was applied to the sacrum while the subject kneeled on the bed. For hip lateral rotators, the IASTM treatment was applied to the gluteus maximus and gluteus medius while kneeling in a prone position with knee and hip flexion. Similarly, for the hamstring bilaterally, the IASTM treatment was applied to the biceps femoris, semitendinosus, and semimembranosus while in a prone position. The instrument was used for about 20 seconds in a direction parallel to the muscle fibers being treated and then for an additional 20 sec perpendicular to fibres
Active Comparator: Transverse friction massage; therapist will perform the transverse friction massage using their thumb to apply pressure across the muscle fibers of Quadratus Lumborum	Other: Transverse friction massage; patient was lying prone while the therapist administered a transverse friction massage to the affected area. Before the massage, the therapist cleansed and dried the place to be treated, ensuring it was free of dirt or debris. The therapist used their palpation skills to locate the site of pain and apply the massage technique accordingly. The therapist performed the transverse friction massage using their thumb to apply pressure across the muscle fiber, with each repetition lasting for two minutes

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numeric Pain rating scale(NPRS)	The Numeric Pain Rating Scale (NPRS-11) has been widely used clinically to assess pain. Universal pain screening with a 0-10 pain intensity numeric pain rating scale (NPRS) has been widely implemented in primary care. The current study will use this scale to measure pain in the lumbosacral joint. A numerical pain rating scale (NPRS) requires patients to rate their pain on a defined scale. For example, 0 is no pain, and 10 is the worst. NPRS scores ≤ 5 correspond to mild, 6-7 to moderate, and scores ≥8 to severe pain regarding pain-related interference with functioning	8 weeks
Range of motion	The range of motion of the lumbosacral joint will be measured through an inclinometer for lumbar flexion (40-60 degrees), extension (20-35 degrees), and rotations (15-25 degrees) range of motion.	8 weeks
Posture	Leg length discrepancy (LLD) is a "direct" measurement using a tape measure that can be utilized to measure the "true" leg length from the anterior superior iliac spine (ASIS) to the medial malleolus. The "apparent" leg length is measured from the umbilicus to the medial malleolus, considered normal up to 1 cm, with mild LLD ranging from 1 to 2 cm, moderate LLD from 2 to 5 cm, and severe LLD greater than 5 cm	8 weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Faiza Amjad, PhD, Riphah international universiy

Study record dates

Study Major Dates

• Study Start (Actual): May 2, 2023
• Primary Completion (Actual): December 23, 2023
• Study Completion (Actual): July 2, 2024

Study Registration Dates

• First Submitted: February 20, 2025
• First Submitted That Met QC Criteria: March 4, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: March 4, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease; Syndrome
• Other Study ID Numbers: REC/RCR &AHS/24/0127

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