Comparison of Post Facilitation Stretch Versus Reciprocal Inhibition in Quadratus Lumborum Syndrome: a Randomized Controlled Trial

Not Applicable

Recruiting

• Conditions: Quadratus Lumborum Syndrome
• Interventions: Other: Post Facilitation Stretch; Other: Reciprocal Inhibition; Other: Conventional Physical Therapy

• Registration Number: NCT06534853
• Lead Sponsor: Foundation University Islamabad

Brief Summary

This study is a randomised control trial and the purpose of this study is to determine the effects Post facilitation stretch versus reciprocal inhibition on pain, lumbar range of motion, apparent leg length discrepancy and lumbar lordotic angle in Quadratus Lumborum Syndrome.

Detailed Description

The purpose of this study is to determine the difference between Post facilitation, stretch versus reciprocal inhibition on pain, lumbar range of motion, apparent leg length discrepancy and lumber lordotic angle in Quadratus Lumborum Syndrome.

The individual of Age 18-35 years among both genders, who experiences pain of 3 ≤ on NPRS from at least 3 months and whose pain decreases on supine lying; along with any two of the following findings positive of quadratus lumborum on physical examination i.e., Taut bands, Local tenderness, Patient's pain recognition, Pain referral to greater trochanter, Local twitch response \& Jump sign will be recruited in the study as patients of Quadratus lumborum syndrome.

Pain levels will be assessed using the Numeric Pain Rating Scale (NPRS). Inclinometer will be used for measuring lumber ranges. To assess apparent leg length discrepancy measuring tape will be used. The lumbar lordotic angle will be measured using 60 cm flexible ruler. Participants of interest would be approached and explained about the research. Informed written consent will be taken. It is a non-blinded study and randomization will be done through sealed envelope. Both groups will receive conventional intervention. Additionally, Group A will receive quadratus lumborum post facilitation stretches while Group B will receive Reciprocal inhibition. Baseline and post intervention scores would be recorded for both groups.

Study Timeline

• Study Start: 2023-09-01
• Status Verified: 2024-07
• Study First Submitted: 2024-07-30
• Study First Submitted QC: 2024-07-30
• Last Update Submitted: 2024-07-30
• Study First Posted: 2024-08-02
• Last Update Posted: 2024-08-02
• Primary Completion: 2025-01-15
• Study Completion: 2025-01-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 42

Inclusion Criteria

• Age 18-35 years

• Both genders

• Having pain of ≤ 8 on NPRS from at least 3 months

• Pain decreases on supine lying

• Any two of the following findings positive of unilateral quadratus lumborum on physical examination:

  1. Taut bands
  2. Local tenderness
  3. Patient's pain recognition
  4. Pain referral to greater trochanter
  5. Local twitch response

Exclusion criteria:

• Painful isometric muscle testing of hip flexors, abductors, adductors, and extensors
• Previous surgery of lower limb
• Centralization/peripheralization
• Lower back trauma
• Positive SLR
• Radiculopathy
• Fracture/surgery of pelvic and/or hip region
• Diagnosed fibromyalgia or other rheumatic diseases.
• Lactating women
• Intrauterine device
• Pregnant women
• Use of psychiatric medications

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
PFS Group	Post Facilitation Stretch	Group A along with Post facilitation stretch of quadratus lumborum will a comprehensive therapeutic regimen that includes a 10-minute session of hot pack therapy specifically targeted at the low back region. In addition to this, participants will receive trigger point release therapy to alleviate muscle tension. The treatment plan also incorporates a tailored exercise protocol designed to enhance back health and strength. This protocol includes: 1. Back isometric exercises 2. Bridging exercises 3. Cat and camel stretches 4. Prone press-ups 5. Abductor strengthening exercises
RI Group	Reciprocal Inhibition	Group B along with Reciprocal inhibition of quadratus lumborum will a comprehensive therapeutic regimen that includes a 10-minute session of hot pack therapy specifically targeted at the low back region. In addition to this, participants will receive trigger point release therapy to alleviate muscle tension. The treatment plan also incorporates a tailored exercise protocol designed to enhance back health and strength. This protocol includes: 1. Back isometric exercises 2. Bridging exercises 3. Cat and camel stretches 4. Prone press-ups 5. Abductor strengthening exercises
PFS Group	Conventional Physical Therapy	Group A along with Post facilitation stretch of quadratus lumborum will a comprehensive therapeutic regimen that includes a 10-minute session of hot pack therapy specifically targeted at the low back region. In addition to this, participants will receive trigger point release therapy to alleviate muscle tension. The treatment plan also incorporates a tailored exercise protocol designed to enhance back health and strength. This protocol includes: 1. Back isometric exercises 2. Bridging exercises 3. Cat and camel stretches 4. Prone press-ups 5. Abductor strengthening exercises
RI Group	Conventional Physical Therapy	Group B along with Reciprocal inhibition of quadratus lumborum will a comprehensive therapeutic regimen that includes a 10-minute session of hot pack therapy specifically targeted at the low back region. In addition to this, participants will receive trigger point release therapy to alleviate muscle tension. The treatment plan also incorporates a tailored exercise protocol designed to enhance back health and strength. This protocol includes: 1. Back isometric exercises 2. Bridging exercises 3. Cat and camel stretches 4. Prone press-ups 5. Abductor strengthening exercises

Primary Outcome Measures

Name	Time	Method
Lumbar Range of Motion (ROM)	2 weeks	It will measured using inclinometer
Lumbar Lordotic Angle	2 weeks	It will be measured using Flexible Ruler
Pain intensity	2 weeks	Pain is assessed by using numeric main rating scale comparing pre and post pain intensity. This is 11- point numeric scale ranges from '0' representing one pain extreme (e.g., "no pain") to '10' representing the other pain extreme
Leg Length Discrepancy (LLD)	2 weeks	Measure the distance between the anterior superior iliac spine (ASIS) and the medial malleolus.This method, referred to as the "direct" clinical method for measuring LLD, provides the apparent leg length discrepancy.

Trial Locations

Locations (1)

Foundation University College of Physical Therapy; 🇵🇰 Rawalpindi, Punjab, Pakistan