Effect of Hip Extension Mobilization on Functional Disability in Patients With Spondylolisthesis (EM)

this study will be conducted to investigate the effect of hip extension mobilization on lumber disability, pain and flexion range of motion in patients with spondylolisthesis

Study Overview

• Status: Not yet recruiting
• Conditions: Spondylolisthesis
• Intervention / Treatment: Other: hip extension mobilization; Other: conventional treatment

Detailed Description

Spondylolisthesis is a kind of low back pain (LBP) that involves displacement of one vertebral body relative to the vertebra below it. Spondylolisthesis is derived from the Greek words spondylosis, which means vertebra, and olisthisis, which means slippage. The displacement of the cranial vertebra can be anterior (also known as anterolisthesis), lateral, or posterior (retrolisthesis) to the more caudal vertebra., most commonly occurring as an anterior slippage at the lumbosacral junction(L5-S1). The condition can result from several etiologies including congenital, isthmic, degenerative, traumatic, or pathologic causes. The clinical presentation of spondylolisthesis encompasses a broad spectrum, ranging from asymptomatic cases to those involving debilitating pain, neural compromise, and functional limitations. Degenerative spondylolisthesis (DS) predominantly affects older adults, with a marked predilection for females. A cross-sectional epidemiological survey involving over 4,000 patients reported a prevalence of 2.7% in men and 8.4% in women, underscoring a significant sex disparity.The most common site for degenerative spondylolisthesis is the L5 to S1 level. Mobilization increases hip range of motion, decreases pain and improves hip function more than non-weight bearing exercises.

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

Contacts and Locations

• Study Contact: Name: Alaa Kazamel, master; Phone Number: 01203016831; Email: alaaahmedkazamel@gmail.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Chronic female Patients diagnosed as grade 1 lumbar degenerative spondylolisthesis (anterolisthesis) referred from Orthopedists was confirmed by lumbosacral x-ray
• Patients age ranged from 40 to 60 years.
• BMI(25:35)
• Ambulant patient with or without cane.
• Cooperative patients with ability to understand instructions and follow simple verbal commands.

Exclusion Criteria:

• Osteoporosis.
• Pregnancy.
• Signs consistent with nerve root compression (reproduction of low-back or leg pain with a straight leg raise at less than 45°, muscle weakness involving a major muscle group of the lower extremity, diminished lower extremity muscle stretch reflex, or diminished or absent sensation to pinprick in any lower extremity dermatome).
• General tumors, spinal tumor, fracture, cauda equina syndrome, and previous surgery.
• Other causes of spondylolisthesis.
• Patients with (BMI ≥ 35)
• Severe or life-threatening psychiatric illness.

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: hip extension mobilization; Sixteen patients received hip extension mobilization with conventional treatment (William spinal flexion exercises and TENS) three times per week for one month.	Other: hip extension mobilization; the patients will receive hip extension mobilization to increase hip extension range of motion; the therapist applies an anterior glide mobilization-usually with the patient in a prone position. The patient is positioned in prone at the edge of the table. The hip is then flexed, abducted, and externally rotated into position as tolerated by the patient, and the foot is placed next to the contralateral knee. Impart anterior mobilization through the greater trochanter. The therapist applies a grade IV mobilization in a posterior to anterior direction to target the anterior hip. The mobilizing hand applies a downward ward force through an extended elbow; body weight exerts the force+ cinentional treatment; Other: conventional treatment; Each subject will be given treatment of 30-40 minute session of William flexion exercises. The seven variations of Williams's exercises include (Pelvic tilt, single knee to chest, double knee to chest, half sit-up, hamstring stretch, hip flexor stretches, and squat). in additionn, The TENS electrodes are typically placed bilaterally along the lumbar paraspinal region directly over the painful area. The frequency of the output was set at 4 to 8 Hz. Continuous type used.
Active Comparator: conventional treatment; Sixteen patients received conventional treatment in the form of William's spinal flexion exercises and TENS three times per week for one month.	Other: conventional treatment; Each subject will be given treatment of 30-40 minute session of William flexion exercises. The seven variations of Williams's exercises include (Pelvic tilt, single knee to chest, double knee to chest, half sit-up, hamstring stretch, hip flexor stretches, and squat). in additionn, The TENS electrodes are typically placed bilaterally along the lumbar paraspinal region directly over the painful area. The frequency of the output was set at 4 to 8 Hz. Continuous type used.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
low back disability	Arabic version of Roland Morris Disability will be used to assess low back disability. it is a valid, reliable 24-item tool used to assess physical disability in patients with low back pain (LBP). It has been culturally adapted to Modern Standard Arabic, with a score ranging from 0 to 24, where higher scores indicate greater functional disability.	up to four weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pain intensity	The visual analogie scale will be used to assess pain intensity. it is a one-dimensional instrument used to assess subjective pain intensity. It comprises a 10-cm (100-mm) line; with 0 refer to no pain while 100mm refer to extreme pain.	up to four weeks
lumbar flexion range of motion	The BROM device will be used for lumbar flexion ROM.	up to four weeks

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Estimated): April 25, 2026
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): June 1, 2026

Study Registration Dates

• First Submitted: April 17, 2026
• First Submitted That Met QC Criteria: April 17, 2026
• First Posted (Actual): April 23, 2026

Study Record Updates

• Last Update Posted (Actual): April 23, 2026
• Last Update Submitted That Met QC Criteria: April 17, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Spondylolisthesis; functional disability; hip extension mobilization
• Additional Relevant MeSH Terms: Bone Diseases; Musculoskeletal Diseases; Spinal Diseases; Spondylolysis; Spondylosis; Spondylolisthesis
• Other Study ID Numbers: P.T.REC/012/005861

Drug and device information, study documents

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