Comparing Different Physiotherapy Interventions on APT in Non Specific Low Back Pain

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age20-40
SponsorNational Orthopedic and General Hospital

About this trial

Anterior pelvic tilt (APT) is a prevalent postural deviation characterized by excessive forward rotation of the pelvis, often resulting in increased lumbar lordosis. This condition is frequently associated with non-specific low back pain (NSLBP), which affects a significant portion of the global population and poses substantial challenges for individuals' well-being and healthcare systems worldwide. NSLBP is a multifactorial condition with various etiological factors, including poor posture, muscle imbalances, sedentary lifestyle, and biomechanical abnormalities such as APT. Understanding and effectively managing APT in the context of NSLBP is crucial for reducing pain, improving functional capacity, and enhancing quality of life for affected individuals .

Despite the prevalence and clinical significance of APT in NSLBP, there is a lack of comprehensive research comparing the effectiveness of different therapeutic interventions. Various approaches have been proposed, including core stability exercises, soft tissue release with manual therapy, stretching and flexibility exercises, and postural correction exercises . However, the relative efficacy of these interventions remains uncertain, hindering evidence-based decision-making in clinical practice.

A variety of therapeutic interventions have been proposed for managing APT and NSLBP, aiming to address underlying biomechanical imbalances, improve musculoskeletal function, and alleviate pain. Core stability exercises, focused on strengthening the deep stabilizing muscles of the spine and pelvis, have shown promise in improving postural alignment and reducing NSLBP symptoms. Soft tissue release techniques, such as manual therapy and myofascial release, target tight and restricted muscles associated with APT, promoting relaxation and improved range of motion. Stretching and flexibility exercises aim to elongate tight musculature, particularly in the hip flexors and lumbar extensors, thereby reducing excessive pelvic tilt and alleviating NSLBP. Additionally, postural correction exercises focus on retraining optimal alignment and body mechanics, promoting a more neutral pelvic position and reducing strain on the lumbar spine.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age: Participants must be between 20 and 40 years old.

Gender: Both genders, Male and Female have equal chance of selection as participant in the study.

Diagnosis: Participants must have a confirmed diagnosis of non-specific low back pain (NSLBP), altered lumbar posture, restricted range of motion of lumbar spine due to muscular spasm etc., altered anterior pelvic tilt angle by a qualified healthcare professional, based on standardized diagnostic criteria (e.g., clinical examination, imaging studies).

Confirmation of Anterior Pelvic Tilt (APT): Participants exhibiting APT confirmed through physical assessment by a trained examiner. This confirmation will involve the use of standardized measures such as digital inclinometers or goniometers.

Disqualifiers

Trauma or Fracture: Individuals with a history of trauma or fracture around the pelvic and lumbar region, as this may significantly affect the participant's ability to perform the prescribed exercises and interventions and confound study outcomes.

Orthopedic or Neurological Surgery: Participants with a history of orthopedic or neurological surgery related to the pelvic or lumbar region, as this may impact the participant's musculoskeletal function and response to the interventions.

Malignancy: Individuals with a diagnosis of malignancy, as this may introduce confounding variables and complicate the interpretation of study outcomes.

Autoimmune Disorders: Participants with autoimmune disorders affecting musculoskeletal function, as these conditions may influence the participant's response to interventions and introduce variability in study outcomes.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Core stability exercises with electrotherapy

    Other intervention

    electrotherapy modalities for pain control will be used and exercises strengthening abdominal core muscles will be applied in two phases.

  • Soft tissue release with manual therapy and stretching

    Other intervention

    Manual soft tissue release will be performed and then stretching of back muscles and thigh muscles will be added to treatemnet.

  • Postural correction exercises with contrast therapy

    Other intervention

    Hot and cold packs will be used one after other for 10-15mins and specific exercises which are designed to improve posture will be taught and performed

  • combination of electrotherapy with stretching and flexibility exercises

    Other intervention

    some pain reducing electrotherapy modality like TENS will be used and general stretching and flexibility exercises will be performed

Treatment groups

100 Participants
are divided into 4 treatment groups
Group A: Group AExperimental treatment 1 intervention
Group B: Group BExperimental treatment 1 intervention
Group C: Group CExperimental treatment 1 intervention
Group D: Group DExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

APT angle

Anterior pelvic tilt angle will be assessed before, at mid and at end of interventions

Time frame
4 weeks
2

Pain

Pain severity will be assessed using Numeric Pain Rating Scale NPRS. NPRS measures the pain severity quantitatively having zero "0" as no pain at one end and "10" as the worst ever pain at the other end. Higher the score on NPRS, more severe the pain and vice versa.

Time frame
4weeks

Secondary outcomes

1

Balance

Balance will be assessed using Y balnace test

Time frame
4 weeks

Other outcomes

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