This randomized controlled trial aims to compare the effectiveness of Autogenic Inhibition Muscle Energy Technique (MET) and Reciprocal Inhibition MET in individuals with Lower Crossed Syndrome. Participants will be randomly assigned to two intervention groups. One group will receive Autogenic Inhibition MET, while the other will receive Reciprocal Inhibition MET for the iliopsoas, rectus femoris, and erector spinae muscles. Both groups will also perform the same standardized strengthening exercises targeting the transversus abdominis, gluteus maximus, and gluteus medius muscles to improve muscle balance and functional outcomes.
Age 19-35 years.
Both genders will include in this study.
According to Janda's Approach, Clinical diagnosis of LCS based on ≥3 positive clinical tests.
Patient with positive modified Thomas test, Patients with a positive testing of prone hip extension test, Patients with a positive test of trunk flexion test, Patients with tight erector spinae muscles.
Leg symptoms when walking, eased in flexion (Signs of stenosis)
Pain due to repetitive movement
Lumbar Radiculopathy
Neurological Symptoms (Paresthesia/numbness)
Parallel
Autogenic Inhibition (Group A)
Procedure/SurgeryExperimental Group 1 will receive MET based on autogenic inhibition using Modified Post-Facilitation Stretch (PFS) for the iliopsoas, rectus femoris, and erector spinae. For the iliopsoas, subjects will assume modified Thomas position and perform a 30% isometric contraction for 7-10 seconds, followed by relaxation and hip extension stretching for 30 seconds. For rectus femoris, the procedure will be performed in modified Thomas position with knee flexion, followed by hip extension and knee flexion stretching for 30 seconds. For erector spinae, subjects will sit with legs hanging and arms crossed, perform a 30% isometric contraction for 7-10 seconds, followed by trunk flexion for 30 seconds. Each technique will include 30-second rest and 3-5 repetitions. From the 3rd to 6th week, strengthening will include TA activation, gluteus maximus bridging, and gluteus medius abduction.
Reciprocal Inhibition
Procedure/SurgeryExperimental Group 2 will receive MET based on reciprocal inhibition for the iliopsoas, rectus femoris, and erector spinae. For the iliopsoas, subjects will assume modified Thomas position and perform a 30% isometric contraction of the gluteus maximus for 7-10 seconds, followed by relaxation and passive hip extension stretching for 30-60 seconds. For rectus femoris, subjects will assume modified Thomas position followed by a 30% isometric hamstring contraction for 7-10 seconds and passive stretching into hip extension with knee flexion for 30-60 seconds. For Erector Spinae, subjects will sit with legs hanging and perform a 30% isometric transverse abdominis contraction for 7-10 seconds, followed by trunk flexion for 30-60 seconds. From the 3rd to 6th week, strengthening will include TA activation, gluteus maximus bridging, and gluteus medius abduction.
Lumbar Extensor Muscle Length
The Modified Schober's Test will be used to assess lumbar extensor muscle length and lumbar spine mobility. The increase in distance between standardized spinal landmarks during maximal forward flexion will be measured and recorded in centimeters (cm). A greater increase in distance indicates greater lumbar extensor flexibility or length.
Functional Movement dysfunction
Functional Movement Screen will be used to assess functional movement dysfunction. It consists of seven tests, scored on a 0-3 scale, with a total score ranging from 0 to 21. Lower scores indicate greater movement dysfunction.
Back Pain
Pain intensity will be assessed using the Numerical Pain Rating Scale, ranging from 0 (no pain) to 10 (worst possible pain). Participants reporting pain intensity scores of 0-6 on the NPRS will be eligible for inclusion in the study.
Functional Disability
Functional disability will be assessed using the Oswestry Disability Index (ODI), a 10-item questionnaire, with each item consisting of six response options.
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