Effects of Sahrmann's Versus Janda Approach in Lower Crossed Syndrome Patients

June 8, 2026 updated by: Riphah International University

Effects of Sahrmann's Versus Janda Approach on Pain, Pelvic Tilt and Lumbar Lordosis in Lower Crossed Syndrome Patients

Muscular imbalance due to prolonged sitting or standing posture leads to a condition lower cross syndrome(LCS) or lumbopelvic syndrome. Several stretching and strengthening regimens are used to treat cross pattern of muscular tightness and weakness in LCS. This study aims to compare the effects of Sahrmann's versus Janda's approach on pain, pelvic tilt and lumbar lordosis in lower crossed syndrome patients.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This study will be a randomized clinical trial and will be conducted in physiotherapy department of Rasheed Hospital, DHA. Non probability convenience sampling will be used to collect data. Sample size of 54 with age group between 18 to 40 years will be taken. Data will be collected from the patient who fulfilled the criteria of LCS. Outcome measures will be taken by using Numeric Pain Rating Scale (NPRS) for pain, I Handy Level for Pelvic tilt, flexible ruler for lumbar angle. An informed consent will be taken. Subjects will be selected on the basis of inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. Group A will receive Sahrmann's exercise protocol while group B will receive Janda's Approach. Both groups will receive 10 mins heating pad and 10 mins Tens for muscle relaxation. Outcome measures will be measured at baseline and then at 4th week. Data Analysis will be done by IBM SPSS version 21.

Study Type

Interventional

Enrollment (Estimated)

54

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 Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000

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:

  • • Gender (both)

    • Age (18 to 40)
    • Participants who fulfilled the criteria of lower cross syndrome

Exclusion Criteria:

  • • Any serious pathology i.e. Neoplasm

    • Any history of trauma
    • Spinal malalignment i.e. Scoliosis
    • Receiving any other form of Physical therapy 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: Sahrmann's approach
Dr. Shirley Sahrmann's approach-rooted in her concept of Movement System Impairment (MSI) Syndromes-takes a functional, movement-based approach to postural dysfunctions like lower crossed syndrome (LCS). Rather than treating LCS strictly as a static structural cross-syndrome, her model emphasizes analyzing how the body moves in daily life
Other: Sahrmann's approach
  1. single knee to chest and double knee to chest
  2. Rectus femoris stretching
  3. kneeling psoas stretch
  4. piriformis stretch in pigeon pose
  5. lying piriformis stretch
  6. Sit and reach stretch

1.Clamshell (side lying) strengthening of gluteus medius 2.Hip abduction gluteus medius strengthening 3.Extension of femur 4.isometric abdominal contraction(top to floor) 5. abdominal contraction(cat exercise)
Active Comparator: Janda Approach
The Janda approach to Lower Crossed Syndrome (LCS) corrects muscle imbalances caused by prolonged sitting or poor posture. It targets an alternating "cross" of tight and weak muscles-specifically tight hip flexors/lower back muscles and weak glutes/abdominals-to relieve low back pain and restore proper pelvic alignment.
Other: Jandas approach
1.50 to 70 degrees of trunk flexion 2.Pelvis tilting 3.One leg standing 4.Quadreped position (forward and backward movement) 5. Quadruped position (raising opposite arm and leg) 6. pelvic bridging 7.One leg bridge 8.Side Plank 9.Abdominal bracing 10. Knee active bending 90 degrees 11. Half Crunch

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Numeric pain rate scale (NPRS) for pain
Time Frame: upto 4 weeks
The Numeric Pain Rating Scale (NRS) is an 11-point, standardized assessment tool used to measure subjective pain intensity. Ranging from 0 ("no pain") to 10 ("the worst pain imaginable"), it provides healthcare providers with a quick and reliable method to evaluate pain severity, track symptom changes, and measure treatment effectiveness
upto 4 weeks
Flexible Ruler for lumbar Lordosis (degree)
Time Frame: upto 4 weeks
To measure lumbar lordosis using a flexible ruler (flexicurve), mold it to the curvature of your spine from T12 to S2. Trace the curve onto paper to find the curve's length (\(L\)) and the maximum perpendicular height (\(H\)). Calculate the angle in degrees using the equation: \(\theta = 4 \times \arctan(2H/L)\).
upto 4 weeks
I Handy Level for Pelvic tilt(degree)
Time Frame: upto 4 weeks
The examiner performed the process three times, and during those three trials, the best view was acquired, the normal average anterior pelvic tilt angle is 9.6±3.5 and 11.7±3.8° in males and females, respectively
upto 4 weeks

Collaborators and Investigators

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

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Samrood Akram, PhD*, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

May 30, 2026

Primary Completion (Estimated)

July 30, 2026

Study Completion (Estimated)

August 30, 2026

Study Registration Dates

First Submitted

June 8, 2026

First Submitted That Met QC Criteria

June 8, 2026

First Posted (Actual)

June 11, 2026

Study Record Updates

Last Update Posted (Actual)

June 11, 2026

Last Update Submitted That Met QC Criteria

June 8, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR&AHS/25/0113 Rahila

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

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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