PURPOSE: to investigate The Efficacy of lumbar spine correction training on postural awareness and stability in patients with low back pain. Patients with low back pain demonstrate impairments in function and range of motion to deficits in patient's quality of life.
HYPOTHESES: It will be hypothesized that there will be no statically Effect of lumbar spine correction training on postural awareness and stability in patients with low back pain
Their ages range from 25 to 45 years.
Both sex
Low back pain for more than 6 months.
Normal body mass index (18.5 - 29 Kg/m2).
Patients with any other Neurological deficits, psychiatric disease lumbar myelopathy, Cognitive problems, vertebral fractures and previous history of spine or lumbar surgery.
Clinical instability, recent trauma
Structural abnormalities of the spine, osteoporosis, and spasmodic torticollis.
Inflammatory or other specific disorders of spina such as ankylosing spondylitis and rheumatoid arthritis
Parallel
lumbar spine correction training
Other interventionThe patients will be mainly trained with trunk control exercise inform of: the trunk muscle against gravity and a Swiss ball for training on an unstable surface. Also the program will include Postural correction exercise inform of: Abdominal drawing-in breathing, upper body raising, bridge exercise, quadruped and spinal extension exercises will carried out
conventional treatment
Other interventionTherapeutic Ultrasound device with patient prone lying position paravertebral in posterior aspect of back, Transcutaneous Electrical Nerve Stimulation (TENS) in the prone position, the electrodes will be positioned on the patient's pain area with a frequency of 100Hz , Heat application: in the form of (hot packs) for 15 minutes on posterior aspect of back as the patient will be in prone lying position and Core strengthening exercises
postural habits and awareness scale (PHAS)
The Postural Habits and Awareness Scale (PHAS) is a 19-item, 5-point Likert scale developed to assess individuals' self-perceived postural habits and their conscious awareness of posture Scoring: The scale is scored from 1 (completely disagree) to 5 (completely agree), with 7 items being reverse-coded. where higher scores indicate better postural habits and greater awareness.
Oswestry Low Back Pain Disability Questionnaire
The Oswestry Disability Index (ODI) a patient-completed questionnaire which gives a subjective percentage score of level of function (disability) in activities of daily living in those rehabilitating from low back pain. Each item consist of 6 statements which are scored from 0 to 5. With 0 indicating the least disability and 5 the greatest then the total score is calculated as a percentage, with 0% indicating no disability and 100% indicating the highest level of disability
multidirectional reach test
The Multi-directional reach test is an inexpensive, reliable, and valid tool for measuring the limits of stability as derived by reach in four directions. Values obtained on relatively healthy older adults serve as norms for screening patient populations
visual analogue scale (VAS)
The visual analogue scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" and "worst pain
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