[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100658761":3},{"organization":4,"outcomesModule":7,"designInfo":18,"detailedDescription":27,"studyPopulation":17,"armGroups":28,"interventions":41,"overallOfficials":50,"centralContacts":54,"locations":59,"responsibleParty":78,"collaborators":17,"id":80,"slug":81,"hasResults":82,"nctId":83,"briefTitle":84,"officialTitle":85,"acronym":17,"eligibilityCriteria":86,"healthyVolunteers":82,"sex":87,"minAge":88,"maxAge":89,"enrollmentInfo":90,"targetDuration":17,"studyType":93,"phases":94,"briefSummary":96,"conditions":97,"keywords":99,"overallStatus":62,"whyStopped":17,"lastUpdateSubmitDate":103,"lastUpdatePostDateStruct":104,"startDateStruct":107,"completionDateStruct":109,"leadSponsor":111,"locationsCount":112},{"fullName":5,"class":6},"Riphah International University","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":17,"otherOutcomes":17},[9,13],{"measure":10,"description":11,"timeFrame":12},"Oswestry Disability Index","Each component receives a score ranging from 0 to 5, with a score of 5 signifying the most severe disability. We calculate the index by dividing the total score by the range of scores. To obtain a numerical representation of the index as a percentage, we multiply the result by 100.","Baseline; 4 Weeks",{"measure":14,"description":15,"timeFrame":16},"Numeric Pain Rating Scale","This scale is commonly used in the scientific literature and clinical practice, as it is reliable and responsive in LBP (r=0.61) and has a minimal clinically important difference of 1.99 points. This is 11 points scale ranges from 0 to 10. 0 indicates \"no pain\" and 10 indicates \"worst pain\"(26). NRS revealed that r = 0.95 with BPI pain interference; r = 0.68 with MODI, test-retest reliability is strong","Baseline; 4 Week",null,{"allocation":19,"interventionModel":20,"interventionModelDescription":17,"primaryPurpose":21,"observationalModel":17,"timePerspective":17,"maskingInfo":22},"RANDOMIZED","PARALLEL","TREATMENT",{"masking":23,"maskingDescription":17,"whoMasked":24},"DOUBLE",[25,26],"PARTICIPANT","OUTCOMES_ASSESSOR","Infact, there is evidence that NSLBP subjects show an increase in center of pressure (CoP) displacement and velocity; and proprioceptive deficits, probably as a consequence of pain . Studies have reported LBP patients show significantly lower hip abductor and extensor strength compared to healthy adults and show weakening of the hip abductor or weakening of the hip extensors.\n\nQuadratus Lumborum (QL) is a major cause of LBP difficulties, which frequently results in active and latent MTrP. Chronic LBP has been associated with changes in trunk muscle responses and increased muscle fatigability. This postural response alters the biomechanics of the spine, with the hips adopting an increased bend, which triggers a concomitant increase in the activation of the musculature surrounding the lower back and hip extensors.\n\nThe QL muscle is important in body mechanics and lumbar spine stabilization. Poor body mechanics and posture affects body positioning and stresses quadratus lumborum muscle which ultimately leads to myofascial trigger points in muscle. Increasing load also brings with it changes in spinal curvatures in both females and males. These increases in forward lean and back muscle activation, in addition to changes in spinal curvature, can heighten the risk of developing low back pain (LBP).\n\nNSLBP has no definitive pathology regarding what is causing the pain but has been theorized to be caused by factors including poor posture, impaired flexibility, previous history of injury, heavy lifting, mental stress, and obesity. The prevalence of non-specific LBP increases with age, presenting a worse clinical course and a greater probability of transition to chronicity.\n\nManual therapy is a common treatment for severe low back pain. The strength and endurance of the trunk muscles play a crucial role in reducing pain, enhancing stability, and maintaining spinal function. Various treatments have been proposed for alleviating LBP, such as stretching exercises , heat therapy , massage therapy, proprioceptive neuromuscular facilitation and myofascial release.\n\nDespite the number of treatment modalities detailed in the physiotherapy literature, there is no single conclusive treatment that has demonstrated to be effective for treating low back pain. Whole body vibration (WBV) is currently increasing in popularity as a treatment modality for alleviating pain, enhancing muscle activities and improving health-related quality of life.\n\nThe muscle energy technique is an active technique requiring the participant to contribute in an accurately regulated manner to the voluntary contraction of the muscle of a subject against the counterforce of an operator. MET is a manual therapy that utilizes gentle muscle contractions of the patient to relax muscles, lengthen them, and restore normal joint motion. This technique was pioneered in 1948 by Fred Mitchell, Doctor of Osteopathic Medicine, to enhance musculoskeletal function by mobilizing joints and stretching tight muscles and fascia.\n\nThe objective of MET is to promote muscle relaxation and lengthening, consequently enhancing joint range of motion (ROM). It is generally recognized as a gentle manual therapy technique for addressing limited motion in the spine and extremities. Depending on the comparative acuteness of the scenario, the contraction is generally started from or short of a previously identified obstacle of resistance. The mechanisms by which MET generates enhanced ROM is still under study. MET's effectiveness in relaxing the impacted muscles is due to the Golgi tendon organs inhibiting motor activity. Thus the shortened tissues attain a greater degree of ease and extra movement. The SCS method is an indirect manipulative method for treating muscle trigger points as its therapy action moves away from the restrictive obstacles, i.e. towards ease.\n\nThe strain counter strain (SCS) technique is one of the effective osteopathic treatment methods. It is a passive positional intervention aimed at relieving musculoskeletal dysfunction and pain. It is achieved by putting the tissues in an optimal position of comfort (POC). POC's aim is to decrease tender point irritability and normalize the dysfunction related to tissue. It is established by the soft and atraumatic nature of SCS methods as a secure and efficient primary mode of action in the therapy of painful muscles and the joints that affect them.\n\nOsteopathic techniques including SCS have been addressed in peer-reviewed literature showing success. The intervention to treat chronic low back pain using SCS method can be regarded as a type of manipulative spinal soft tissue therapy because the pelvis, sacrum, and lower limbs are used passively in degrees of flexion, expansion, lateral flexion, and rotation in the placement of the lumbar spine and sacral areas.\n\nThis study will offer a thorough comparison of SCS and MET that could offer insight into their mechanisms and inform optimal clinical decision-making for long-term management of NSLBP and can help to understand which mechanism offers superior outcomes or if they are equally effective.",[29,35],{"label":30,"type":31,"description":32,"interventionNames":33},"Strain Counter Strain","EXPERIMENTAL","Group A will receive strain counter strain technique for Quadratus Lumborum, Gluteus Medius, Multifidus, Erector Spinae and Iliopsoas muscles, for 1 set with 3 repetitions separated by a 30 seconds rest period and 3 sessions for a week along with conventional treatment for a total of four weeks. Pre and post intervention values will be taken on 1st day and after 4 weeks Common treatment will comprise moist heat for 10 minutes as an adjunct (2); Stretching of back, piriformis and hamstrings, hold the stretch for 30 seconds in 2 sets with 3 repetitions; and strengthening of back and abdominal muscles. Exercises consisted of 15 repetitions, 2 times with rest periods in between, with 3 sessions every week for a total of four weeks",[34],"Other: Group A",{"label":36,"type":37,"description":38,"interventionNames":39},"Muscle Energy Techniques","ACTIVE_COMPARATOR","Group B will receive muscle energy technique for Quadratus Lumborum, Gluteus Medius, Iliopsoas, Multifidus and Erector Spinae muscles; for 2 sets, 3 repetitions in a single session with a break of two minutes in between each repetition and 3 sessions for a week along with conventional treatment for a total of four weeks. Measurements were made before and after the intervention Common treatment will comprise moist heat for 10 minutes as an adjunct (2); Stretching of back, piriformis and hamstrings, hold the stretch for 30 seconds in 2 sets with 3 repetitions; and strengthening of back and abdominal muscles. Exercises consisted of 15 repetitions, 2 times with rest periods in between, with 3 sessions every week for a total of four weeks",[40],"Other: Group B",[42,46],{"type":6,"name":43,"description":44,"armGroupLabels":45,"otherNames":17},"Group A","Group A will receive strain counter strain technique for Quadratus Lumborum, Gluteus Medius, Multifidus, Erector Spinae and Iliopsoas muscles, for 1 set with 3 repetitions separated by a 30 seconds rest period and 3 sessions for a week along with conventional treatment for a total of four weeks. Pre and post intervention values will be taken on 1st day and after 4 weeks",[30],{"type":6,"name":47,"description":48,"armGroupLabels":49,"otherNames":17},"Group B","Group B will receive muscle energy technique for Quadratus Lumborum, Gluteus Medius, Iliopsoas, Multifidus and Erector Spinae muscles; for 2 sets, 3 repetitions in a single session with a break of two minutes in between each repetition and 3 sessions for a week along with conventional treatment for a total of four weeks. Measurements were made before and after the intervention",[36],[51],{"name":52,"affiliation":5,"role":53},"Syed Shakil ur Rehman, PhD","PRINCIPAL_INVESTIGATOR",[55],{"name":52,"role":56,"phone":57,"phoneExt":17,"email":58},"CONTACT","+92 320 786661","Shakil.urrehman@riphah.edu.pk",[60],{"facility":61,"status":62,"city":63,"state":64,"zip":65,"country":66,"countryCode":67,"cosmosGeoPoint":68,"geoPoint":73,"contacts":74},"Riphah Rehabilitation Clinic","RECRUITING","Lahore","Punjab Province","54000","Pakistan","PK",{"type":69,"coordinates":70},"Point",[71,72],74.35071,31.558,{"lat":72,"lon":71},[75],{"name":52,"role":56,"phone":76,"phoneExt":17,"email":77},"+92 320 7866611","shakil.urrehman@riphah.edu.pk",{"type":79,"investigatorFullName":17,"investigatorTitle":17,"investigatorAffiliation":17,"oldNameTitle":17,"oldOrganization":17},"SPONSOR","100658761","strain-counter-strain-and-muscle-energy-technique-in-non-specific-low-back-pain-100658761",false,"NCT07854028","Strain Counter Strain and Muscle Energy Technique in Non-specific Low Back Pain","Effects of Strain Counter Strain Versus Muscle Energy Technique on Pain, Range of Motion and Disability in Non-specific Low Back Pain","Inclusion Criteria:\n\n* Participants should age between 20-40 years.\n* Both gender were included.\n* Participants were required to have experienced LBP lasting three to six months.\n* According to Simons' criteria participants were required to have at least 3 active myofascial trigger points (MTrPs) in their lower back muscles.\n* 20-40% score on the Oswestry Disability Index (ODI), have Numerical Pain Rating Scale \\[NPRS\\] ≥ 4.\n\nExclusion Criteria:\n\n* The patients with red flag conditions; disc prolapse, spinal stenosis, lumbar radiculopathy and spondylosis were excluded.\n* Patients who had undergone previous surgery within the last six months, psychiatric or mental deficiencies, pregnancy, or lactation.\n* Participants with conditions, like osteoporosis, kidney and gastrointestinal disorders.\n* Individuals with a history of spinal surgery or spinal fractures.\n* Participants with congenital leg length discrepancy","ALL","20 Years","40 Years",{"count":91,"type":92},62,"ESTIMATED","INTERVENTIONAL",[95],"NA","Low back pain (LBP) is a condition characterized by fatigue, discomfort in the lumbosacral area, and a most common cause of disability . Low Back Pain (LBP) is defined as tiredness, discomfort or pain in the lower back region, radiating to lower extremities unilaterally or bilaterally. Low back pain is a bit common issue that most of the population experience sooner or later in their lives .\n\nLow back pain (LBP) is featured as pain and discomfort in the area between the costal margin and the inferior gluteal folds, with or without referred leg pain. Non-specific low back pain is the most common back pain, it is estimated that 70-80% of the entire population has experienced non-specific low back pain in their lifetime.\n\nNonspecific low back pain (LBP) is usually defined as pain, muscle tension, or stiffness localized below the costal margin and above the inferior gluteal folds. It is the commonest musculoskeletal condition in the adult population and its prevalence amounts to 84%. Furthermore, it limits the activity of the affected population by 30.8% monthly and 38% every year. Consequently, CLBP poses a substantial economic burden on healthcare, social, and welfare systems.\n\nOnly 15% of non-specific low back pain can be identified, while the remaining 85% are non-specific. Sixty to eighty percent of LBP patients report pain or disability a year later, and up to 40% report chronic pain. However, understanding the specific etiology of chronic nonspecific LBP remains elusive because it results from a variety of factors that can interact with each other.\n\nThe diagnosis of Low Back Pain is divided into two, namely Specific and Non-specific Low Back Pain, In Specific Low Back Pain, there are certain pathophysiological mechanisms that cause symptoms such as infections of the spine, hernia nucleus pulposus, osteoporosis, rheumatoid arthritis, fractures, and tumors. In contrast to non-specific low back pain, where it is generally said that 80-90% of non-specific causes of low back pain are mechanical, and based on this percentage, 65-70% have no specific cause.\n\nAdditionally, LBP restricts occupational activities and is among the main causes of absenteeism. So, it leads to high costs of health care and decreases productivity. Various factors contribute to the development of chronic LBP. Physical factors, such as reduced muscle strength and endurance are prognostic factors for chronic LBP. The occupational load carriage has the potential to alter the carrier's body posture and may lead to greater forward trunk lean.\n\nBesides, the presence and experience of nonspecific LBP could be affected by psychosocial factors, including anxiety and depression. These factors strongly influence the pain intensity during activity and degree of disability in patients with chronic nonspecific LBP. Apart from load carriage, other factors are also associated with LBP in these populations including a lack of physical fitness, higher fat mass, and long periods of sitting.\n\nPain is the main symptom and account for disability and lack of work participation. Physiological testing shows reduced lumbar flexibility and flexion-relaxation, poorer static balance , poorer proprioception and spinal segment stability, and lower physical fitness and health-related quality of life (HRQoL) in patients with NLBP .\n\nQuadratus lumborum (QL) is a deep trunk muscle, and its tightness can trigger symptoms of significant low back tightness and discomfort. Recurrent episodes (lasting more than 3 months) are common presentations of nonspecific LBP usually accompanied by limitation of movement, long-term disability, and decreased quality of life.",[98],"Low Back Pian",[100,101,102,30],"Disability","Low Back Pain","Muscle energy technique","2026-09-27",{"date":105,"type":106},"2026-10-02","ACTUAL",{"date":108,"type":106},"2026-06-01",{"date":110,"type":92},"2026-12-01",{"name":5,"class":6},1]