Objective: The aim of this study was to compare the differences between the effect of myofascial release technique versus cupping technique on pain intensity level, spinal mobility and functional disabilities level in patients with NSLBP.
Methods: The study participants were 60 patients from both genders diagnosed as NSLBP. Their age ranged from 45 to 55 years old. They were assigned randomly into two groups: Group A (MFR): 20 patients received MFR and conventional physical therapy treatment. Group B: 20 patients received cupping technique and conventional physical therapy treatment. Group C: 20 patients received conventional physical therapy treatment only. All groups received treatment protocols three times a week for 4 consecutive weeks.
patients age ranged from 45 to 55 years old and body mass index of 18.5-24.9 (kg/m2) with NSLBP of 3 or more month's duration.
All patients reported pain score of 4-6 based on the visual analog scale (VAS). 3.Patient with limitation in range of motion of lumbar spine due to tightness of the muscles, hypersensitive tender points on palpation along with pain localized para spinally .
Patients presented with lumbar radiculopathy
spinal pathology (fracture or tumors) or history of any spinal surgery
lumbar canal stenosis, osteoporosis
pregnancy related back pain, and spinal deformities like scoliosis or kyphosis.
Single group
I. Myofascial Release Technique ,Cupping Technique and II. Conventional Physical Therapy
Other interventionThe cupping procedure was performed as follows: Massage oil was applied over the area first to improve contact and makes it easier to move the cup's position. double-walled glass cups (6 glasses with diameters from 75 to 100 mm) were held inverted, after which each glass was placed on an afflicted area overlying the low back muscle (acupoint: BL23). Myofascial Release Technique Vertical stroking technique was performed in lumbar region to quadratus lumborum. AIt was performed as follow; Quadratus lumborum is palpated in prone and side lying for trigger points. The technique is applied by the patient positioned in side lying with a pillow under waist to exaggerate stretch of the muscle. The therapist stands at level of patient's hip posterior and counter pre
pain in low back area
Visual analog scale (VAS) was used to assess the intensity of perceived pain pre and post treatment in patients with NSLBP. The VAS is a reliable and valid tool for the quantification of perceived pain
Functional Disability
Level of daily living activities was measured using Oswestry Disability Index (Ar-ODI).The questionnaire contains 10 items related to limitations in daily life activities (like personal care, lifting, walking, sitting, standing, sleeping, social life, traveling, and work).Each item includes six potential responses that are rating on a 0 to 5 points scale, with maximum scores of ''5'' or ''total disability'' and a minimum score of ''0'' or ''no disability.'' 39-41 The total score is calculated as follows: (patient' score/50) \*100 to obtain the score expressed in percentage
Assessment procedure of lumbar flexion and extension ROM
Two inclinometers were used to measure lumbar flexion and extension. The examiner stood behind the standing subject. The skin was marked along the spine midway between two posterior superior iliac spines (PSIS), and one mark was made on the spinous processes, 15 cm superior to the PSIS line. Both inclinometers were placed over the skin marks.
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