The goal of this clinical trial is to compare the effects of McGill stabilization exercises and Sahrmann's movement-based exercise protocol in adults with chronic non-specific low back pain. The study aims to determine which exercise program is more effective in reducing pain, improving lumbar range of motion, and decreasing functional disability.
The main questions it aims to answer are:
Do McGill stabilization exercises reduce pain, improve lumbar range of motion, and decrease disability in individuals with chronic non-specific low back pain? Are McGill stabilization exercises more effective than Sahrmann's movement-based exercise protocol in improving pain, lumbar range of motion, and functional disability?
Researchers will compare the McGill stabilization exercise group with the Sahrmann exercise group to determine which intervention provides greater improvements in clinical outcomes.
Participants will:
Be randomly assigned to either the McGill stabilization exercise group or the Sahrmann exercise group.
Receive baseline physiotherapy, including hot pack application, Transcutaneous Electrical Nerve Stimulation (TENS), lumbar isometric exercises, pelvic tilts, knee-to-chest exercises, and manual therapy.
Attend supervised treatment sessions 2-3 times per week for 6 weeks. Complete outcome assessments before and after treatment using the Numeric Pain Rating Scale (NPRS) for pain, the Oswestry Disability Index (ODI) for disability, and a bubble inclinometer to measure lumbar range of motion.
This study will provide evidence on the comparative effectiveness of two commonly used physiotherapy exercise protocols and help identify the most effective rehabilitation approach for managing chronic non-specific low back pain.
Adults aged 20-50 years.
Male and female participants.
Diagnosed with chronic non-specific low back pain lasting more than 12 weeks.
Pain intensity of 3-4 on the Numeric Pain Rating Scale (NPRS) at baseline.
History of spinal surgery.
Presence of neurological deficits.
Structural spinal deformities.
Pregnancy or within 6 months postpartum.
Parallel
McGill Stabilization Exercise Protocol
BehavioralA progressive exercise program consisting of McGill stabilization exercises aimed at enhancing core muscle endurance, spinal stability, and neuromuscular control while reducing pain and improving lumbar function in individuals with chronic non-specific low back pain.
Sahrmann's Exercise Protocol
BehavioralA progressive movement-based exercise program designed to improve motor control, activate deep stabilizing muscles, correct faulty movement patterns, and enhance functional performance in individuals with chronic non-specific low back pain.
1. Numeric Pain Rating Scale (NPRS)
Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS). The NPRS is a valid and reliable self-reported pain assessment tool that measures pain intensity on an 11-point scale ranging from 0 ("no pain") to 10 ("worst imaginable pain"). Participants will be asked to select the number that best represents their current pain intensity. A decrease in the NPRS score indicates an improvement in pain following the intervention.
2. Oswestry Disability Index (ODI)
Functional disability will be assessed using the Oswestry Disability Index (ODI). The ODI is a disease-specific, validated questionnaire used to evaluate disability associated with chronic low back pain. It consists of 10 sections covering pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life, travelling, and employment/homemaking. Each section is scored from 0 to 5, with higher total scores indicating greater disability. A reduction in the ODI score reflects improvement in functional status and daily activities.
3. Bubble Inclinometer
Lumbar range of motion (ROM) will be measured using a bubble inclinometer, a reliable and valid instrument for assessing spinal mobility. Measurements will be obtained for lumbar flexion, extension, right and left lateral flexion, and right and left rotation according to standardized measurement procedures. The bubble inclinometer provides objective assessment of lumbar spinal movement in degrees. An increase in lumbar range of motion indicates improvement following the intervention.
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