Thorakal mobilitet versus hofte mobilitetsøvelser til kerne stabilisering ved lumbal spondylitis (TME-HME)

In the Core stabilization exercises (control group)patients will receive Core stabilization exercises as Abdomen Curl ,Supine Bridging ,Bird Dog , Side Bridging , Plank , Curl Up and Sitting On Ball. In each session. The exercises will consist of 3 levels (from easy to difficult). In the advanced level exercises, resistance limb exercises will be added and the exercises will be completed gradually. Each exercise will be performed for 3 sets of 8-10 repetition.

Core stabilization exercises include Abdomen Curl ,Supine Bridging ,Bird Dog , Side Bridging , Plank , Curl Up and Sitting On Ball In each session. The exercises will consist of 3 levels (from easy to difficult). In the advanced level exercises, patients will be asked to maintain the neutral curvature of the lumbar spine, resistance limb exercises will be added and the exercises will be completed gradually. Each exercise will be performed for 3 sets of 8-10 repetition.

In the thoracic Mobility Exercises group ( experimental group B) will receive core stabilization Exercises program(as Abdomen Curl ,Supine Bridging ,Bird Dog , Side Bridging , Plank , Curl Up and Sitting On Ball. In each session) in addition to thoracic Mobility Exercises as (Thoracic extension with foam roller ,Thoracic extension with chair ,Thoracic flexion in quadruped , Right Thoracic rotation in side lying ,Left Thoracic rotation in side lying , Right kneeling Thoracic rotation , Left kneeling Thoracic rotation , Right Thoracic sitting lateral flexion and Left Thoracic sitting lateral flexion .Each exercise will be performed for 3 sets of 10 repetitions in addition to core stabilization program

receive thoracic Mobility Exercises as movements in all directions of thoracic spine as (Thoracic extension with foam roller ,Thoracic extension with chair ,Thoracic flexion in quadruped , Right Thoracic rotation in side lying ,Left Thoracic rotation in side lying , Right kneeling Thoracic rotation , Left kneeling Thoracic rotation , Right Thoracic sitting lateral flexion and Left Thoracic sitting lateral flexion) .Each exercise will be performed for 3 sets of 10 repetitions.

will receive core stabilization Exercises program(as Abdomen Curl ,Supine Bridging ,Bird Dog , Side Bridging , Plank , Curl Up and Sitting On Ball. In each session) The exercises will consist of 3 levels (from easy to difficult). In the advanced level exercises, resistance limb exercises will be added and the exercises will be completed gradually. Each exercise will be performed for 3 sets of 8-10 repetition.

will receive core stabilization Exercises program(as Abdomen Curl ,Supine Bridging ,Bird Dog , Side Bridging , Plank , Curl Up and Sitting On Ball. In each session) in addition to hip mobility exercises program The patients will perform 8 different hip mobility exercises; reverse v-ups, butterfly, frog, internal rotation with foot rise, pike, revolved crescent lunge, pigeon, lunge on the knee. Each exercise will be performed for 2 sets of 20 seconds.

will receive core stabilization Exercises program(as Abdomen Curl ,Supine Bridging ,Bird Dog , Side Bridging , Plank , Curl Up and Sitting On Ball. In each session) in addition to hip Mobility Exercises (The patients will perform 8 different hip mobility exercises; reverse v-ups, butterfly, frog, internal rotation with foot rise, pike, revolved crescent lunge, pigeon, lunge on the knee. Each exercise will be performed for 2 sets of 20 seconds).

will receive core stabilization Exercises program(as Abdomen Curl ,Supine Bridging ,Bird Dog , Side Bridging , Plank , Curl Up and Sitting On Ball. In each session) The exercises will consist of 3 levels (from easy to difficult). In the advanced level exercises, resistance limb exercises will be added and the exercises will be completed gradually. Each exercise will be performed for 3 sets of 8-10 repetition.

Questionnaire measuring functional disability caused by low back pain. Modified Oswestry Disability Index Arabic Version (MODI-Ar).

Pain intensity assessed by using the Numerical Pain Rating Scale (NPRS-Ar) consist of 11 points from 0-10 ( 0) mean no pain and (10) maximum pain .

The Back Range of Motion (BROM) device will be utilized to measure the lumbar range of motion (ROM). The BROM device will be used to measure active ROM in the order of flexion/extension, right/left lateral flexion, and right/left rotation and the value from 0 degree 360 degre which 0 means no motion and 360 max motion.

Once the data for each movement was taken, the BROM device was removed, and the skin markers were reapplied after a 10-15 second rest period. Each motion will have three trials, and data from the three trials will be averaged and used for analysis in order to maximize reliability.

Using Modified Schober Test . to measurement of lumbar spine flexion where 15cm above and 5cm below the lumbosacral junction (L5-S1) is marked and the difference in distance is measured on forward flexion.

Using (Tampa Scale for Kinesiophobia Arabic Version (Tampa-Ar). to measures fear of movement and re-injury in patients with chronic musculoskeletal pain, on a 4-point Likert scale (1=strongly disagree to 4=strongly agree).

measured by RAND 36-Items health syrvey which measures physical and emotional and social functioning the total score 100 and higher score means good health.