Effect of Muscle Energy Technique on Latissimus Dorsi on Pain , Functional Disability and Range of Motion in Patients With Mechanical Low Back Pain

Mechanical low back pain (LBP) stems from spinal structures or surrounding tissues, often caused by overuse or trauma, and is prevalent globally with high recurrence rates. Key contributing factors include biomechanical, psychological, and social elements. The latissimus dorsi (LD), along with other back muscles, plays a crucial role in lumbar stability via the thoracolumbar fascia. Stretching the LD has shown positive effects in reducing pain and improving function in chronic LBP patients. Physical therapy treatments include manual therapy, core stabilization, and flexibility exercises. Muscle Energy Techniques (MET), particularly targeting the LD, can enhance flexibility and spinal mobility when applied correctly.

Study Overview

• Status: Recruiting
• Conditions: Mechanical Low Back Pain
• Intervention / Treatment: Procedure: Conservative physical therapy; Procedure: Post-facilitation stretch of latissimus dorsi with conservative physical therapy

Detailed Description

Mechanical low back pain (MLBP) originates from structural components of the spine, such as intervertebral discs, muscles, ligaments, or joints, and is commonly caused by repetitive trauma, poor posture, or overuse. It is a leading cause of functional disability worldwide, with high recurrence rates. Physiotherapy plays a central role in managing MLBP by addressing contributing biological, psychological, and social factors. The latissimus dorsi (LD) muscle, due to its anatomical connection with the pelvis via the thoracolumbar fascia (TLF), significantly influences lumbar stability. Impaired extensibility or overactivity of the LD can contribute to mechanical dysfunction. Incorporating LD stretching into rehabilitation protocols has shown enhanced outcomes in pain reduction and functional improvement. Muscle Energy Techniques (MET), particularly Post Facilitation Stretching, utilize controlled muscle contractions to improve flexibility and relieve tension in shortened muscles. Proper application of MET targeting the LD has demonstrated effectiveness in increasing range of motion and supporting spinal stability in patients with chronic low back pain.

• Study Type: Interventional
• Enrollment (Estimated): 32
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Laraib Khurshid, DPT; Phone Number: +923135965114; Email: laraibhamza20@gmail.com

Study Locations

• Pakistan
  • Punjab Province
    • Rawalpindi, Punjab Province, Pakistan, 46000
      • Recruiting
      • Foundation University Islamabad
      • Contact: Ali Bin Asim, MS-SPT; Phone Number: +923135088144; Email: ali.asim@fui.edu.pk

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Patients had low back pain for more than 3 months Moderate disability (20 to 40 %) determined through Oswestry Disability Index Subjects with pain ranging 3 to 8 on NPRS Able to perform ROM of lumbar spine (flexion and extension) within range of pain Patient were not under any medical treatment (analgesics etc) both male and female

Exclusion Criteria:

• presence of any red flags (i.e tumor , metabolic disease, rheumatoid arthritis , osteoporosis , history of use of steroids ) SLR test positive Muscle weakness or paralysis of lower extremity Prior surgery of lumbar spine and pregnancy Any psychological problem

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
Active Comparator: Conservative physical therapy; Hot pack + TENS (10 min), followed by a structured program of warm-up, 20-minute core/back strengthening, stretching (hip flexors, hamstrings, lumbar extensors), and cool-down exercises.	Procedure: Conservative physical therapy; Hot pack + TENS (10 min), followed by a structured program of warm-up, 20-minute core/back strengthening, stretching (hip flexors, hamstrings, lumbar extensors), and cool-down exercises.
Experimental: Post facilitation stretch of latissimus dorsi with conservative physical therapy; Receives the same conservative physical therapy as the control group plus Latissimus Dorsi Muscle Energy Technique (isometric contraction for 10seconds, relaxation 2-3seconds, followed by 10seconds stretch, applied bilaterally each session).	Procedure: Post-facilitation stretch of latissimus dorsi with conservative physical therapy; Receives the same conservative physical therapy as the control group plus Latissimus Dorsi Muscle Energy Technique (isometric contraction for 10seconds, relaxation 2-3seconds, followed by 10seconds stretch, applied bilaterally each session).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Low back pain	Numeric Pain Rating Scale will be used. An 11-point scale comprising a number from 0 through 10; 0 indicates "no pain", and 10 indicates the "worst imaginable pain". Patients are instructed to choose a single number from the scale that best indicates their level of pain.	4 weeks
Functional Disability of back	Oswestry disability index will be used. To evaluate the functional impact of low back pain on a person's daily life. It consists of 10 items on the degree of severity to which back (or leg) trouble has affected the ability to manage in everyday life. The 10 sections cover the pain and the daily function (including pain intensity, personal hygiene, lifting, walking, sitting, standing, sleeping, sexual activity, social activity, and traveling). Each item is rated on a 6-point scale (0-5); the higher score means the higher level of disability related to LBP. The present study used the traditional Chinese version of the ODI 2.1	4 weeks
Range of motion of low back.	Dual Inclinometer will be used. It is a handheld, circular, fluid-filled disc that has a weighted gravity pendulum attached to it that is maintained in the vertical direction. It is graduated by 0.5 degree intervals over 360.	4 weeks

Collaborators and Investigators

• Sponsor: Foundation University Islamabad
• Investigators: Principal Investigator: Laraib Khurshid, DPT, Foundation University Islamabad

Study record dates

Study Major Dates

• Study Start (Actual): January 25, 2025
• Primary Completion (Estimated): December 30, 2025
• Study Completion (Estimated): December 15, 2026

Study Registration Dates

• First Submitted: December 26, 2025
• First Submitted That Met QC Criteria: December 26, 2025
• First Posted (Actual): January 8, 2026

Study Record Updates

• Last Update Posted (Actual): January 8, 2026
• Last Update Submitted That Met QC Criteria: December 26, 2025
• Last Verified: October 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
• Other Study ID Numbers: FUI/CTR/2025/07

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No