Effects of Hip Hinge Exercises on Pain, Range of Motion and Functional Disability in Non-specific Low Back Pain.

For Group A 3 session per week within pain-free limits, progressing as tolerated and 45-60 minutes time per session.

Functional drills focusing on hip flexion with neutral spine including body weight hip hinging with dowel feedback and progression as tolerated. Exercises will emphasize gluteus activation and eccentric protocol to minimize lumbar flexion.

Spine bridges and clamshells to strengthen the Gluteus Maximus and Medius, addressing posterior chain weakness commonly seen in NSLBP.

Active and static stretching for hip flexors and extensors in pain free range of motion.

For Group B 3 sessions per week within pain free range of motion as tolerated and session last for 45- 60 minutes per session

Core stabilization exercises such as abdominal bracing, pelvic tilts, quadruped arm/leg extensions, trunk strengthening prone back extensions and lumbar stretching.

The intensity of NSLBP will be measured on the Numeric pain rationg scale which will be assessed verbally by a blinded assessor. This scale is routinely utilized for NSLBP, and is valid, responsive and is easy to administer in a clinical setting. The NPRS is scored on an 11 point scale (0-10) where 0 represents no pain and 10 represents the worst imaginable pain. Excellent interrater reliability, excellent internal consistency for NPRS in participants aged 25-55 (Cronbach's alpha =0.88)

The Oswestry Disability Index (ODI) is a validated self-report questionnaire used to measure functional disability related to low back pain. It includes items on pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life and travel. Scores range from 0-100% where higher scores indicate greater disability. ODI is recognized as a gold standard outcome in NSLBP clinical trails and exhibits excellent reliability and responsiveness in adults with chronic low back pain.

Lumbar ROM will be assessed using a manual goniometer according to standard clinical protocols. Common movements measured include lumbar flexion (forward bending), extension (backward bending), lateral flexion (side bending) and rotation. Lumbar ROM assessment has demonstrated acceptable reliability for clinical use and movement deficits have been associated with NSLBP in biomechanical studies.