Effects of Post-Isometric Relaxation and Myofascial Release on Low Back Pain With Lower Cross Syndrome

March 22, 2026 updated by: Bushra Madad Ali Malik, University of Karachi

Combined Effects of Post-Isometric Relaxation and Myofascial Release in Patients With Low Back Pain and Lower Cross Syndrome: A Randomized Controlled Trial

This randomized controlled trial aims to evaluate the combined effects of post-isometric relaxation and myofascial release on pain, flexibility, and functional disability in individuals with low back pain associated with lower cross syndrome. Eligible participants aged 18 to 45 years will be randomly allocated into two parallel intervention groups. One group will receive post-isometric relaxation combined with myofascial release, while the comparison group will receive conventional stretching combined with Therapeutic modalities. Outcomes will be assessed at baseline and after completion of the intervention period. The results of this study are expected to contribute to evidence-based physiotherapy management of low back pain associated with postural imbalance.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Pakistan
    • Sindh
      • Karachi, Sindh, Pakistan
        • Department of Physiotherapy, University of Karachi
        • Contact:
        • Contact:
        • Principal Investigator:
          • BUSHRA MALIK, MPHIL

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Participants aged 18-45 years old
  2. having low back pain persisting for at least 4 weeks
  3. with clinical diagnosis of LCS, and hamstring tightness (AKE >15°)

Exclusion Criteria:

  1. Participants with the history of spinal surgery active neurological conditions
  2. systemic disease affecting connective tissue (Rheumatoid arthritis, Systemic lupus erythematosus)
  3. recent lower limb or spinal injury (within 6 months)
  4. pregnancy or inability to lie prone for treatment.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Post-Isometric Relaxation and Myofascial Release Group
Participants in this group will receive post-isometric relaxation combined with myofascial release targeting the hamstring muscles as part of a supervised physiotherapy program.
Other: post isometric relaxation
Post-isometric relaxation will be applied to the hamstring muscles. Participants will be positioned supine with the hip flexed to 90 degrees and will perform a submaximal isometric contraction of the hamstrings against therapist resistance for 5 to 8 seconds, followed by a passive stretch of approximately 10 seconds. The procedure will be repeated three times per limb per session.
Other: MYOFASCIAL RELEASE
Myofascial release will be applied to the hamstring muscles with the participant in a prone position. Sustained manual pressure will be applied along the length of the hamstring muscles using the therapist's hands for approximately 30 seconds per application, repeated multiple times per session to improve tissue extensibility.
Active Comparator: Conventional Stretching and modalities Group
Participants in this group will receive conventional static hamstring stretching combined with therapeutic modalities, including ultrasound or superficial heat, as part of standard physiotherapy care.
Other: Conventional Static Stretching
Conventional static stretching of the hamstring muscles will be performed with the participant in a supine position. Each stretch will be held for approximately 30 seconds and repeated three times per limb per session as part of routine physiotherapy management.
Other: Therapeutic Modalities
Therapeutic modalities, including ultrasound therapy or superficial heat application using a heating pad, will be applied prior to stretching to reduce pain and improve tissue extensibility as part of conventional physiotherapy care.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Hamstring Flexibility
Time Frame: Outcome measures will be assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)
Hamstring flexibility will be assessed using Active Knee Extension (AKE) test measured in degrees with a goniometer.
Outcome measures will be assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
pain intensity
Time Frame: assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)
pain intensity measured by Visual Analogue Scale (VAS)
assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)
functional flexibility
Time Frame: Outcome measures will be assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)
assessed by Straight Leg Raise (SLR)
Outcome measures will be assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)
posture assesment
Time Frame: Outcome measures will be assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)
Posture will be assessed using the REEDCO scale
Outcome measures will be assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Karachi

Collaborators

IQRA University

Investigators

  • Study Chair: Basit Ansari, PhD, University of Karachi
  • Study Director: Aftab Ahmed Mirza Baig, PhD, IQRA University
  • Principal Investigator: Bushra Madad Ali Malik, DPT, University of Karachi

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

March 25, 2026

Primary Completion (Estimated)

September 15, 2026

Study Completion (Estimated)

October 20, 2026

Study Registration Dates

First Submitted

March 22, 2026

First Submitted That Met QC Criteria

March 22, 2026

First Posted (Actual)

March 27, 2026

Study Record Updates

Last Update Posted (Actual)

March 27, 2026

Last Update Submitted That Met QC Criteria

March 22, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • MPhil-DPT-Hamstring-2026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared publicly due to institutional policies, ethical restrictions, and to protect participant confidentiality. Data will be used solely for academic and research purposes as approved by the institutional review board.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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